Children's Hospital Lifestyle Medicine Tier 2 (LM2) Program provides comprehensive health care integrated with research study participation to children, adolescents and young adults with obesity and obesity related comorbidities including type 2 diabetes (T2D), polycystic ovary syndrome (PCOS), hypertension, metabolic-associated steatotic liver disease (MASLD), dyslipidemia, sleep apnea, etc. The main focus of this position is to provide initial evaluation and care of patients with newly diagnosed T2D as well as new and follow-up care to patients in our LM2 clinic. This is an opportunity to work with an incredibly collaborative team of physicians, NPs, certified diabetes educators (CDE), nurses, dietitians, psychologists, social workers and pharmacists who have a common goal of improving health disparities for youth with obesity and other related comorbidities. Key Responsibilities: The duties and responsibilities of the position include, but are not limited to: * Triage referrals for pre-adolescents/adolescents/young adults (aged approximately 8-21 years) in the LM2 EPIC pool from LM1 and on-call Pediatric Endocrine providers in conjunction with the LM2 on-call provider and clinical staff to coordinate scheduling of newly referred LM2 patients for initial care, as well as LM2 patients lost to follow-up, hospitalized LM2 patients, and LM2 patients with acute decompensation in need of follow-up care. This includes assessing severity, urgency of need for an appointment, and fit for the LM2 clinic. * Perform detailed history, physical exam and formulate differential diagnosis within scope of practice for clients with new-onset of diabetes. This would entail evaluation, basic diabetes education, education on how to administer medications, education on how to administer injections, and education on how to check and record blood glucoses. * Work closely with medical providers and clinical staff, including our certified diabetes educator (CDE), to coordinate follow-up care for adolescents/young adults (aged 12-21) with newly diagnosed type 2 diabetes * Perform f/u clinical visits in a multidisciplinary clinic for patients with T2D. Scope of work to include medical treatment of the diabetes, referral for bariatric surgery as appropriate, and screening for and treatment of associated comorbidities. * Perform clinical visits in a multidisciplinary clinic for patients with other insulin resistance-associated conditions including hypertriglyceridemia and polycystic ovary syndrome (PCOS). Scope of work to include medical treatment of the primary condition and screening for associated comorbidities. * Perform clinical visits in a multidisciplinary clinic for patients with other insulin resistance-associated conditions including hypertriglyceridemia and polycystic ovary syndrome PCOS). Scope of work to include medical treatment of the primary condition and screening for associated comorbidities. * Assess home blood glucose monitoring, continuous glucose monitoring and medication dosing between visits to adjust diabetes and weight loss medication regimens. * Perform clinical visits as outpatient follow-up on babies with hypoglycemia related to stress hyperinsulinism and home blood glucose monitoring or continuous glucose monitoring to titrate and/or wean hypoglycemia medications. Coordinate safety fast visits to allow medication discontinuation. * Perform clinical visits as outpatient follow-up on secondary adrenal insufficiency to monitor steroid tapers, adrenal recovery and glycemia. Perform oral and injected stress dose teaching. Coordinate scheduling ACTH stimulation testing visits to confirm if the patient is ready for steroid discontinuation and check in on patients during ACTH stimulation testing. * Establish systematic follow-up for evaluation of the plan of care, reassess and modify the plan, as necessary, including initiation of referrals and consultation with physicians and other health care providers as appropriate. * Assure patient and family teaching is adequate to manage the treatment plan at home. * Facilitate client participation and promotes self-care by providing information needed to make decisions and choices. * Work with the program CDE/RN to standardize diabetes educational materials and streamline clinical processes (quality improvement initiatives) |