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: 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, […]

Case Presentation: A 74 -year-old male with a past medical history of hypertension, hyperlipidemia, benign prostatic hyperplasia, renal cell carcinoma status post right nephrectomy, and peripheral arterial disease, presented to the Emergency Room with 20 days of progressive weakness, shortness of breath, nausea, vomiting, polyuria, polydipsia, and abdominal pain. The patient was vaccinated but not […]

Case Presentation: A 58 year old female with history of hypertension, hypothyroidism and noninsulin dependent diabetes mellitus presented with two days of involuntary movements of her right upper extremity. Bloodwork was remarkable for blood glucose 1273MG/DL, anion gap 15, serum creatinine 2.0 MG/DL from normal baseline, no ketosis. Infectious workup with urinalysis, respiratory viral panel […]