# Toward optimizing diabetes care in persons with chronic kidney disease

> **NIH NIH K01** · STANFORD UNIVERSITY · 2020 · $154,040

## Abstract

7. Project Summary/Abstract
The purpose of this K01 proposal is to provide Dr. Jinnie Rhee with the protected time and resources to allow
her to pursue the training needed to reach her long-term goal of becoming an independent investigator in
patient-centered clinical research, and an expert in diabetes epidemiology. Type 2 diabetes mellitus (T2DM)
management in chronic kidney disease (CKD) remains a challenge due to the complexity of multiple
medication regimens that are often needed, and the required pharmacological dose adjustments and
contraindications of several conventional antidiabetic medications. Barriers to achieving optimal T2DM
management in CKD may include low patient adherence, and conservative provider prescription decision-
making, resulting from lack of long-term data on the safety and effectiveness regarding benefits and harms of
certain medication classes over others in patients with CKD, particularly for newer medications with which
there has been little clinical experience in the CKD population. The objective of the proposed research is to
better understand the comparative safety and effectiveness of various strategies aimed to manage T2DM in
CKD, and to understand factors that currently influence patient and provider choice of these strategies through
a series of quantitative and qualitative studies. In Aim 1, Dr. Rhee will conduct a descriptive study to quantify
patterns of conventional and newer antidiabetic medication use across different stages of CKD, and examine
proportions of each medication prescribed by an endocrinologist, nephrologist, or primary care physician. In
Aim 2, Dr. Rhee will use a detailed administrative database to compare the safety and effectiveness of DPP-4
inhibitors and GLP-1 agonists versus conventional antidiabetic medications by examining associations with
cardiovascular outcomes, glycemic control, weight gain, and hypoglycemia-related ED visits and
hospitalizations. Effect modification by CKD stage will also be examined. In Aim 3, Dr. Rhee will conduct a
qualitative study to understand: (1) the perspectives of patients on the use of antidiabetic drugs, including
newer agents, and uncover perceived barriers to, and facilitators of, adherence; and (2) providers’ perspectives
on prescribing conventional and newer antidiabetic medications, and examine both clinical and nonclinical
factors that influence their prescription decision-making. This award will allow Dr. Rhee to transition into a
clinically-minded epidemiologist whose work goes beyond quantitative research. It will help her fill critical
training gaps in the areas of advanced pharmacoepidemiology, health services research, and qualitative
research. The detailed training plan includes formal coursework at Stanford University as well as seminars,
meetings, research apprenticeships, directed readings, and attendance at national/international conferences.
The proposed work has high potential to make a significant public health and clinical im...

## Key facts

- **NIH application ID:** 9928740
- **Project number:** 5K01DK110221-04
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** JINNIE J. RHEE
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $154,040
- **Award type:** 5
- **Project period:** 2017-05-10 → 2022-05-09

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9928740

## Citation

> US National Institutes of Health, RePORTER application 9928740, Toward optimizing diabetes care in persons with chronic kidney disease (5K01DK110221-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9928740. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*