# Sleep Promoting Intervention to Improve Diabetes Outcomes and Executive Function in Adolescents with T1D

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2024 · $750,619

## Abstract

PROJECT SUMMARY
Only 17% of adolescents with type 1 diabetes (T1D) meet the recommended target for hemoglobin A1c,
placing them at high risk for acute and long-term complications of T1D. Thus, there is a critical need for novel
approaches to improve diabetes management in adolescents with T1D. Insufficient and poor-quality sleep
decrease insulin sensitivity, worsen glycemic outcomes and compromise executive function in adolescents,
reducing their ability to effectively manage T1D. In other populations, sleep disturbances are linked to reduced
brain matter integrity and to novel cerebrospinal fluid glymphatic flow. The glymphatic system is a recently
characterized brain-wide interstitial fluid drainage pathway that enables metabolic waste clearance from the
brain, particularly during sleep. Glymphatic clearance occurs through a network of perivascular spaces, and
dysfunction is associated with cognitive impairment. White matter integrity and perivascular fluid, a marker of
glymphatic flow, can be measured through quantitative magnetic resonance imaging (MRI) methods to assess,
for the first time, how disordered sleep may impact brain health in adolescents with T1D. Aim 1. Building on our
pilot work in this population, we will evaluate the effects of a sleep-promoting intervention for adolescents (age
11-17) with T1D on sleep duration and timing via a randomized controlled trial. Our central hypothesis is that
adolescents randomized to the Sleep Coach intervention will exhibit significantly longer sleep duration and
reduced sleep variability as compared to those who receive enhanced usual care. Aim 2: We will evaluate the
effects of a sleep-promoting intervention on executive function and glycemic outcomes (HbA1c, Time in
Range) and diabetes management. Hypotheses: adolescents randomized to the Sleep Coach intervention will
demonstrate improved executive function, improved HbA1c and Time in Range and better diabetes
management, as assessed by validated measures, compared to those who receive enhanced usual care. Aim
3: We will explore whether brain glymphatic flow, assessed via quantitative diffusion tensor imaging along
perivascular spaces with MRI, increases among adolescents with T1D in parallel with increased sleep duration.
We will also assess whether adolescents with increased glymphatic flow exhibit improved executive function
skills. This exploratory aim will aid in understanding of the mechanisms by which disrupted sleep may impair
cognitive function in T1D. Our multidisciplinary team includes a pediatric psychologist, a pediatric neurologist, a
pediatric endocrinologist, and a pediatric neuroradiologist, an imaging physicist and a pediatric sleep expert.
Our Children’s Diabetes Program serves a large, diverse population of children with T1D with a strong history
of clinical research leadership and participation of youth with T1D and their families. This project has the
potential to influence standards of clinical care for adolescents with...

## Key facts

- **NIH application ID:** 10879585
- **Project number:** 1R01DK136695-01A1
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Sarah S Jaser
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $750,619
- **Award type:** 1
- **Project period:** 2024-03-08 → 2029-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10879585

## Citation

> US National Institutes of Health, RePORTER application 10879585, Sleep Promoting Intervention to Improve Diabetes Outcomes and Executive Function in Adolescents with T1D (1R01DK136695-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10879585. Licensed CC0.

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