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This summer, Chi-Yen Yao, School of Medicine (SOM) Class of 2025, was one of just 70 students nationwide chosen to participate in the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) Medical Student Research Program. The three-month program, funded by the National Institutes of Health (NIH), allows medical students, during the summer between the first and second year of medical school, to conduct diabetes-related research under the direction of an established scientist at an NIH-supported diabetes center. 

For her research, Ms. Yao worked with researchers at the Kaiser Foundation Research Institute in Northern California, where at the suggestion of her mentor, a clinical psychologist, she focused on diabetes prevention in people with severe mental illness who are taking antipsychotic medications.

“People with severe mental illness (SMI), including schizophrenia, bipolar disorder and major depression have a substantially increased risk for type 2 diabetes mellitus due to the metabolic side effects of many antipsychotic medications used to treat these conditions, such as rapid weight gain.” said Ms. Yao, who presented her research during a NIDDK virtual student research symposium in July. “While clinical guidelines recommend diabetes screening for individuals taking antipsychotic medications, they are inconsistent on how to prioritize evidence-based diabetes prevention approaches, including lifestyle intervention, switching to a lower risk antipsychotic and adjunctive metformin or topiramate medications, which improve metabolic parameters in this population.”

Ms. Yao conducted a retrospective cohort study using Kaiser Permanente Northern California Electronic Health Record (EHR) for 10,477 adults aged 18-64 to examine the prevalence of the various metabolic side effects for those with SMI.

“What is interesting about this topic is that it is a rather untapped area of research as the last comprehensive U.S. guideline recommendations about diabetes prevention in the SMI population were updated in the early 2000s,” said Ms. Yao. “In addition, contradicting guideline recommendations have been published worldwide. To bring to light how significant people with SMI are affected by diabetes and metabolic dysfunctions, we need to first present the data on the prevalence of the issue. There is not only a need to renew guideline recommendations, but within a hospital system, changes need to be made on how to flag people who are at especially high risk and need intervention as soon as possible to prevent metabolic dysfunctions to develop in the first place and ultimately reduce diabetes.”

Ms. Yao’s interest in researching diabetes stems largely from the prevalence of diabetes in her own family, as well as her experience working in the areas of bariatric surgery and maternal fetal medicine after receiving her undergraduate degree.

“Being chosen to participate in the NIDDK research program was not only exciting but also very meaningful to me,” said Ms. Yao, whose grandmother and uncle both died from complications with type 2 diabetes. “I will always remember the numerous, lengthy trips to a rural Taiwanese county hospital to visit my grandmother who had complications and the handfuls of medications she had to take upon discharge that caused neurological symptoms from drug interactions and just made her worse again.”

“My experience working at Kaiser was phenomenal because I felt extremely supported by my mentor who spent hours teaching me about the topic and by everyone at the Kaiser site involved with the NIDDK program,” said Ms. Yao. “The people I have met at Kaiser through this virtual program were not only very encouraging in teaching on diabetes but also shared clinical pearls on how to be a great physician in any specialty I choose in the future. My great experience at Kaiser is a starting block and has encouraged  me to incorporate more research going forward.”

“Although I am too late to help my grandmother, I know I can contribute to the field of diabetes and obesity by understanding more about prevention, mechanisms of complications and barriers to diabetes care throughout my career.”