Q&A | Angelina Bernier, M.D., of the Joslin Pediatric Clinic
Monday, September 13, 2010
Endocrinologist Angelina Bernier, M.D., works in the Joslin pediatric clinic. Here she answers five questions about her background, her patients with type 2 diabetes and her clinical research.
How did you decide you wanted to become a doctor?
I helped deliver my youngest brother. That kind of turned me away from ballet, and towards medicine!
What then pulled you toward pediatrics, and endocrinology?
I’m the oldest of seven children, so I’ve always been very comfortable taking care of babies and children, and I found pediatrics to be a natural transition.
In regards to endocrinology, I had a friend take me to diabetes camp when I was 18. I loved every bit of it, and I went every year afterwards! It was everything in the world I love the most: medicine, children, the outdoors and sports. I couldn’t have been happier.
When I was finishing up my residency and was deciding on a specialty, endocrinology popped into my head because I knew so much already and had a strong interest in it.
Every bit of my medical training was done in Florida, at the University of Florida at Gainesville, where I was born. My husband’s from Massachusetts and we moved here for my first job.
What’s it like practicing here?
People seek out this clinic because it is so well known and does such a great job; I have some patients from outside the country. Parents tend to be vigilant and for many of my patients, it’s like fine-tuning of their diabetes management. I like that a lot. I also work at Boston Medical Center, which has more inner city children, and I take care of a lot of Latino youth there. I like that population, because the little things you do can make a big difference.
You’re also involved in clinical research?
Yes, one project at Joslin is the TODAY study (Treatment Options for type 2 Diabetes in Adolescents and Youth). That’s a national study looking at type 2 diabetes in youth and adolescence and trying to optimize compliance with medication and other treatment regimens. It looks at providing a lot of support and seeing what it takes to maintain that compliance.
How can you encourage greater compliance?
I have a couple of tricks up my sleeve. Before I’ll consider using medication in a child with pre-diabetes, I’ll expect them to make some changes on their own. I’ll describe the way that with lifestyle changes in addition to medical treatment of their pre-diabetes, the potential for weight loss is much greater, and with this expectation, I find that they’ll make a change in their exercise or eating habits in order to get the additional assistance. I think it works well for me with this population because it makes them feel more empowered.
I try to direct the focus on the child, not the parent so much, because they are adolescents and they want their own control.
Positive reinforcement is the best motivator for these children. For as long as they’ve had pre-diabetes or diabetes, they have heard that they eventually will go blind or their kidneys won’t work, so they become immune to those warnings. What they want is hope.