# Mechanisms underlying the relationship between sleep health and circadian timing with cardiometabolic risk in adolescents with type 1 diabetes

> **NIH NIH R01** · UNIVERSITY OF COLORADO DENVER · 2024 · $524,390

## Abstract

PROJECT SUMMARY
Our research has shown a link between poor sleep health and late circadian timing with cardiometabolic
dysfunction in adolescents with type 1 diabetes (T1D). Further, sleep health and circadian timing of adolescents
with T1D participating in our research was markedly poor compared to age-based recommendations.
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in T1D, which begins as early as
adolescence, and current therapies are limited. Thus, it is imperative to identify countermeasures, such as sleep
health and circadian timing, to improve cardiometabolic health in adolescents with T1D. Our central hypothesis
is that that cardiometabolic dysfunction associated with T1D can be reduced by improving sleep health and
circadian timing. We have successfully increased sleep duration and advanced circadian timing with a combined
behavioral and physiological intervention in adolescents without T1D. Simultaneously intervening on sleep health
and circadian timing may reverse cardiometabolic dysfunction but a gap exists with no research in adolescents
with T1D. Further, no research to date has examined the physiological mechanisms underlying the relationship
between sleep health and circadian timing and cardiometabolic dysfunction in adolescents with T1D.
We therefore propose to utilize a combined sleep health and circadian timing intervention as a mechanistic probe
to understand relationships with cardiometabolic health in adolescents with T1D. Utilizing a randomized clinical
trial design and a combined free-living and in-laboratory paradigm, we will compare the effect of 1 month of
optimally-timed, low-dose PM melatonin and AM bright light exposure plus increased time in bed to an attention-
matched control condition in adolescents with T1D. We will evaluate changes in insulin resistance, glycemic
control, and vascular functioning using rigorous assessment methods, and determine physiological mechanisms.
We hypothesize that insulin sensitivity, glycemic control, and vascular function will improve with a combined
sleep and circadian intervention, and that inflammation, cortisol, and leptin will act as mediators. This proposal
will provide an understanding of mechanisms underlying the relationship between sleep health and circadian
timing and cardiometabolic dysfunction in adolescents with T1D which is urgently needed as a first step towards
developing new therapies to mitigate CVD in T1D.

## Key facts

- **NIH application ID:** 10948592
- **Project number:** 1R01HL174735-01
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Stacey Lynn Simon
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $524,390
- **Award type:** 1
- **Project period:** 2024-09-01 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10948592

## Citation

> US National Institutes of Health, RePORTER application 10948592, Mechanisms underlying the relationship between sleep health and circadian timing with cardiometabolic risk in adolescents with type 1 diabetes (1R01HL174735-01). Retrieved via AI Analytics 2026-06-05 from https://api.ai-analytics.org/grant/nih/10948592. Licensed CC0.

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