Background: Diabetes is an exceedingly common disease encountered by medical trainees, with over 8 million hospitalizations in 2018 listing type 1 or type 2 diabetes as a diagnosis (1). Evidence supports continuing certain oral diabetes medications during admission when safe, reflected in recent consensus statements from professional societies (2,3). Nevertheless, oral medications are often held […]

Background: Patients with diabetes who are hospitalized with COVID-19 have been found to have increased lengths of stay and greater intensive care unit utilization compared to those without diabetes. Diabetic ketoacidosis (DKA) is an acute diabetes emergency that accounts for a high number of hospitalizations, hospital readmissions, and healthcare utilization. Our study aims to evaluate […]

Case Presentation: A 59 year-old man presented with one week of progressive pain, swelling, and weakness of the right lower extremity. The pain was most severe in his right thigh, hip, and buttocks. He also developed numbness of the right foot and ankle. He reported no leg trauma, incontinence, or new medications. His past medical […]

Background: Hospitals generally have clear protocols, often nursing driven, for management of inpatient hypoglycemia. The American Diabetes Association recommends a standardized approach to hypoglycemia management in the hospital to address hypoglycemia. A frequent cause of hypoglycemia is poor management of the first hypoglycemia episode. Standard treatment protocols include the use of oral carbohydrate agents for […]

Background: Studies have demonstrated that oral medications such as metformin are safe to continue in the hospital, and that when insulin is used in a hospital setting, a basal or basal-bolus regimen is more effective than sliding scale monotherapy (1-2). Despite mounting evidence and society guidelines, clinicians have been slow to adopt these practices in […]

Case Presentation: LF is a 63 year-old female with a history of schizoaffective disorder, gastroparesis, and stage III chronic kidney disease (CKD) who was initially admitted to the inpatient psychiatric unit for psychosis with suicidal and homicidal ideation in the context of medication nonadherence. Mental status exam was remarkable for persecutory delusions and auditory hallucinations. […]

Case Presentation: A 46-year-old male with Type 2 DM presented with 2 weeks of malaise, 3 days of cough, dyspnea, and fatigue. His wife noted his breath smelt different over the last 2 weeks. He had a thyroidectomy for multinodular goiter 2 weeks prior and started a ketogenic, intermittent fasting diet after. Medications include empagliflozin […]

Background: In the US, a small number of patients with complex medical and psychosocial needs disproportionately consume healthcare resources. At our institution, the HOME Program provides dedicated Individualized Care Plans (ICPs) and care coordination for patients with a range of chronic illness. Among such illnesses, Type 1 Diabetes Mellitus accounts for a large portion of […]

Case Presentation: A 60 year old female with small cell cancer, type 2 diabetes on an insulin pump and empagliflozin, and recently diagnosed pulmonary embolus (PE) on apixaban presents to the hospital with intractable nausea with vomiting and symptomatic tachycardia. This patient presented 1 month prior with dyspnea and tachycardia and was found to have […]

Case Presentation: This is a case of a 72-year-old male with Stage III metastatic melanoma. The patient was started on combination immunotherapy with ipilimumab and nivolumab three months prior. He completed three cycles of treatment. He presented to the emergency department with complaints of fatigue and lethargy. Initial assessment of vitals showed hypotension, BP 95/61 […]