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 [...]

Background: Diabetic Ketoacidosis (DK)A at our center has historically been managed in the intensive care unit (ICU) utilizing low-dose insulin infusion. According to the American Diabetes Association (ADA) and a 2016 Cochrane review, cases of mild to moderate DKA can be safely managed on general medical floors utilizing subcutaneous short-acting insulin. Prior studies have demonstrated [...]

Case Presentation: 29-year-old man with no significant medical history presented with 1 day of severe epigastric pain and multiple episodes of emesis and nausea. He denied any alcohol use.​Vitals: ​Remarkable for a heart rate of 110. ​Notable Labs & Imaging:​Bicarbonate 16 mmol/L with an anion gap of 23 ​Glucose 117 mg/dL​Lactate 2.9 mmol/L​Lipase 531 U/L​Normal [...]