Background: Over 8 million Americans with diabetes require insulin for disease management. Insulin is a high-risk medication with immense potential for harm. Transitions of care from the hospital to ambulatory settings are particularly prone to error. Studies have suggested a substantial number of insulin prescriptions at hospital discharge contain errors which can result in increased [...]

Case Presentation: A 65 year old woman with hypertension, hyperlipidemia, and gastric bypass surgery in 2005 presented to the emergency department with episodes of confusion. Four years prior to her presentation she began to have episodes of confusion where she would stare off into space and it was noted that eating relieved these symptoms. She [...]

Case Presentation: A 40-year-old female with a history of morbid obesity status post Roux-en-Y gastric bypass in 2009 presented to hospital with blood glucose level of 33. She reported hypoglycemic episodes every day since 2007 with prior labs demonstrating elevated insulin and low c-peptide levels. The differential diagnoses included exogenous administration of insulin, given she [...]