Background: There is evidence that significantly disruptive health events, such as hospitalizations, may increase patients’ receptiveness to interventions that lead to healthier lifestyle choices and medication adherence. For example, research has shown that hospitalizations are particularly effective settings for delivering some interventions aimed at preventing chronic disease morbidity, such as intervening on tobacco use. Additional […]

Background: Stroke is one of the most common causes of adult mortality. With changes in lifestyle, the increase in risk factors is leading to an increase in the number of cases. Mean platelet volume (MPV) is associated with an increase in platelet size and hence increased production of pro-inflammatory cytokines and increased expression of platelet […]

Background: Diabetic ketoacidosis (DKA) remains one of the commonest causes of medical and intensive care unit hospitalisations. DKA is a preventable hospital admission which is associated with multiple modifiable risk factors. However, little is known about factors that can predict healthcare resource utilisation in DKA. Previous studies have explored clinical and biochemical factors affecting the […]

Background: The effects of diabetes medications on COVID-19 hospitalization outcomes have not been consistent. We sought to determine the effect of metformin, DPP-4 inhibitors (DPP-4i), and insulin on admission to the intensive care unit (ICU), need for assisted ventilation, development of renal insufficiency, and mortality, in patients admitted with COVID-19 infection after controlling for clinical […]

Background: Diabetes mellitus (DM) is a chronic disease where treatment is directed toward reducing and delaying its potentially severe short- and long-term complications. The estimated population (20-79 years old) with diabetes is 32.22 million in the United States, and 12.5% of people live with undiagnosed diabetes (Figure 1). Diabetes Mellitus is currently the most prevalent […]

Background: Approximately one-third of patients with acute ischemic stroke (AIS) develop hyperglycemia regardless of pre-existing history of diabetes [1]. Hyperglycemia is associated with increased risk of hemorrhagic transformation and can be considered as a predictor of poor functional outcome after intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) [2]. Additionally, risk of death, hemorrhagic complications, and […]

Background: Attention to the quality of glycemic management during the hospital stay, including care transitions, has grown with increasing evidence linking inpatient and post-discharge glycemic control to clinical outcomes, widespread use of glucometric benchmarking, and impending pay-for-performance measures. Clinical inertia (nonadherence to guidelines) and therapeutic inertia (failure to adjust medications as indicated) or CTI among […]

Background: Hypoglycemia is common and potentially life-threatening for diabetic patients, often iatrogenic from diabetes treatments. It is important to be able to accurately study rates of hypoglycemia when evaluating the inpatient treatment of diabetes at a systems-level. Discharge diagnosis codes show promise as a tool in the surveillance of hypoglycemic events in large administrative databases […]

Background: Recent work by the authors showed that over half of the incidences of hypoglycemia in hospitalized diabetics involved patients with CKD, and that 18% of patients with diabetes and end-stage renal disease (ESRD) had a hypoglycemic episode while hospitalized. The importance of reducing inpatient hypoglycemia is reflected in the Centers for Medicare and Medicaid […]

Background: Multiple organizations have published clinical guidelines on hyperglycemia management in the acute care setting in non-critically ill patients [1–3], and the Society of Hospital Medicine offers additional support through its Glycemic Control program [4]. However, there remains little consensus regarding specific dosing regimens when designing insulin protocols in the inpatient setting. At our institution, […]