My Internship

Diabetes Mellitus can be defined as an illness that lacks regulation of sugar via insulin; type I and type II are most common and both types can occur in children. Insulin is secreted by the pancreas and helps to regulate sugar for energy use. However, when there is not enough insulin in the body, it results in high sugar levels. Those who have type I diabetes must take insulin because they either have little to no insulin. In type II, there is also an element of decreased insulin sensitivity, and depending on sugar levels, can be treated with only oral medications (i.e metformin) or may also need injectables like insulin. Type I can be associated with genetics and autoimmunity. Type II diabetes is not tied to autoimmunity, but is associated with genetic and environmental factors. Riley's Diabetes Research Team focuses on both forms of diabetes amongst children. One of the ways is accomplished by utilizing a registry of information on diagnosed children. This registry tracks the progression of the illness and related comorbidities from date of diagnosis to follow ups. It has clinical and demographic data sets of hundreds of kids from their diabetic visits. Researchers can use this registry to better understand how diabetes impacts children and look for gaps in care. My role in this internship is to maintain the registry via data extractions. We have recently started a new project that looks at the relationship between BMI and A1C throughout the pandemic.

Supervisor: Anna Neyman, MD & Brett McKinney, BS

Department: Pediatrics & Endocrinology

Learning Skills

This experience will allow for me to develop those skills that will aid me in my journey. It will also give me more insight on the clinical healthcare setting. I want to be able to learn more skills within the clinical settings and how exactly research works. I hope that the contribution I make are just to aid in the projects that are already on-going. I hope to be able to help make the process of extracting DNA run more smoothly. In refining the process it allows for more organization for the database. As of currently, the work that I mostly do is data entry from patient records to the registry. It can get difficult in finding the information necessary for the forms. However, with the cheat sheet I was given it has become much easier. I hope that maybe I can contribute and making the database entry work a much more easier process than what it is now for future references!

As time has progressed and experiences have grown, I have noticed that the more I work with the database the better I get at data extractions and the ability to use the charting technology system used. I have learned how to look for information needed with the help of tips and tricks. I have become more efficient on filling/updating the follow-up forms on the registry. By working with the registry and the charting system I have learned to pinpoint information faster than when I first began!

My contributions have helped greatly, most of the researchers at this site are busy at the clinical sites conducting follow up appointments and seeing patience. So most often the Healthcare workers are busy trying to see patients and write up the clinical notes. In doing so it does not leave them much room to update the registry as well. This is where I come in handy. I mostly spend my time updating all of those said clinical notes into the registry. In doing so I have developed a great skill of reading clinical notes and pinpointing the demographical and biometric data needed. Through working at this site I was able to start a project that looked at the BMI and glycemic changed for already diagnosed children before during and after the restrictions of the pandemic.

The Workplace

After being at this research site for about a month, I am most excited to be able to job shadow at the actual diabetes pediatric clinics and diabetes educators throughout the school year. I am eager to see how these professionals handle things, especially when a child isn't that happy about maintaining a good sugar level. I am also interested to see what kind of resources are offered, who do these resources cater to, and if there is a way of broadening these resources to be more inclusive. Inclusive as in is there diabetes programs that are offered in other languages besides English? Are the pamphlets that are given in the patient and patient family primary language? I feel like to properly provide care to people, you must communicate with them effectively. What good is having an illness, if you can't even understand it?

I feel as though, my communicative personal skills have gotten much better. I can communicate more freely and without fear or anxiety! This not only means I am comfortable with my site but also in the skills that I have as a professional. A skill that I do think that I could be better at is making sure I am more thorough, especially with extracting data from patient files. I need to take things slow and read thing thoroughly before jumping to a conclusion!

Overall, it has been a great month working as an intern!

• I have not been surprised by my day-to-day life at with this work. Although one thing that is unique is getting to read and see the progression of the folks as they treat diabetes. It sometimes makes me happy to see when someone's blood sugars have been steadily under controlled and they have reached their goal! It was much different than I expected because I never realized how important mundane things like extracting data can impact research. There is so much that goes into answering questions that are often overlooked. I have experienced a lot working with people of different education level doing the same things and working towards the same goal of bettering care! A lot of the patients that are seen in these clinics come from many different religious and cultural background. I was even able to help a NP learn more about the religion of Islam and how Muslims eat foods that are Halal, allowed to be consumed based off of Islamic dietary guidelines. It was awesome to see how many different cultures run through these clinics and even better that me and my own background provided some kind of assistance in the clinic!

The workplace culture can truly make or break how much you enjoy your job and what you are working on. It can help boost employee moral, from CEO to supervisor to the day-to-day employee. I truly enjoy the workplace of this site. It genuinely feels as though everyone here is more than willing to help and genuinely care on allowing for me to reach my potential. So much so that I may be able to continue my work outside of LHSI and possibly write an abstract. Which is beyond what I was truly hoping for. My ideal workplace is just as it is with my current internship. A place where I feel confident in the people I work with and that I do not have to fear about asking questions or better understand the project at hand. I feel as though by working with other people who have a different background as I do it allows for me to bring something different to the table.

What I Have Learned So Far

So far as an intern, I feel as though I have learned a lot about research settings. Specifically, the purpose of research, why it is done and ultimately how. Research that I work with is accomplished to better understand and answer the questions that are left unanswered with diabetes. It literally provides a database registry full of information about vital signs, BMI, social/family HX and other comorbidities that are tied with Diabetes 2 in children. This pool of information can provide background and possibly notify on the things that could be bettered in regards to the treatment of Diabetes. Overall, research main purpose is to better understand and answer the unknowns of disease to potentially better the treatments and management plans that are already proposed.

My favorite experience so far has been to job shadow within the clinics ran for Type 2 diabetes in pediatrics. I was able to not only learn about the process of these appointments but also better understand what kind of things do these doctors and nurse practitioners who sees the patients look for. I was able to see from start to finish on how each visit works. It starts with looking at patient history, then when the patient is seen downloading their glucose level data, comparing asking about other symptoms, how they are taking their medications etc. It was a great opportunity to learn about how these professionals go about getting information and then adjusting if needed to provide better care. It made me love the idea of a career in medicine even more.

Successes and Challenges

I feel a huge success is in being able to easily discuss working with my current internship site far beyond when LHSI ends. I do enjoy my work with the registry and we have just began a project of a chart review that gives me the opportunity to be published. A huge success was having that conversation to continue my work with my supervisor and being able to start a project from where I can see how research works from start to finish (i.e going through the IRB etc.)

One of the few challenges I have faced so far is with the weather and travelling to my internship. I usually have to take the IU shuttle from campus to the building and walk for a bit out in the cold. It has been a bit freezing a couple weeks now but I am still glad that there is the IU Health Shuttle system. Another challenge for me this semester and the internship was availability, because of my availability I rarely have time to be able to shadow the clinics that are ran. However, I am working on trying to at least shadow when I can.

• After reflection, these challenges I faced while working here has since changed as of late the weather has been much nicer so the commute hasn't been terrible. As for my availability, both supervisors offered up a good idea to come to clinic at 11:00 if I wanted to still shadow. A new success for me is actually starting the data extraction for my chart review project!