Background: Inpatient hypoglycemia (HG) is common and often avoidable, associated with poor outcomes and high costs, and its prevention reflects hospital performance. We investigated its risk factors and impact on mortality, hospital length of stay (LOS), charges, and readmissions. We defined HG as glucose ≤40 mg/dl (severe), >40 – ≤70 mg/dl (moderate), or euglycemia >70 [...]

Background: Before any gastrointestinal (GI) procedures, it is recommended that patients have no intake of clear liquids (2-4 hours) and solid food (6 hours) prior to induction of sedation to minimize preoperative risks such as regurgitation, pulmonary aspiration, and other risks associated with sedation. These time frames were determined by previous randomized control trials which [...]

Background: Hypoglycemia occurs frequently in hospitalized adults with diabetes, and is associated with adverse clinical events, increased use of rapid response teams, prolonged hospital length of stay, and higher healthcare costs (1). Identifying risk of hypoglycemia in hospitalized adults is vital to preventing adverse events and maximizing patient safety. However, there are no tools/models to [...]

Background: Our standard Hypoglycemia Protocol primarily utilizes juice to treat hypoglycemia. The system currently allows both the Hypoglycemia Protocol and a renal diet to be active simultaneously. This algorithm has no restrictions on administering orange juice to treat hypoglycemia for patients despite exclusion of orange juice for patients on a renal diet. Considering anecdotal instances [...]

Background: Kidney injury significantly reduces renal clearance, posing unique challenges for patients with type II diabetes, particularly those on insulin. This reduced clearance can lead to elevated insulin levels, increasing the risk of hypoglycemia and subsequent complications, which often extend the patient’s length of stay (LOS). Chronic kidney disease (CKD) itself is an independent risk [...]

Case Presentation: A two-day old exclusively breastfed male born at term (no prior medical history; routine prenatal care) was discharged at 36 hours of life from the nursery, 5% down from birth weight. He had difficulty latching to feed post discharge and at 45 hours of life, presented to an outside emergency room in cardiorespiratory [...]

Case Presentation: A 69-year-old male with a history of hypertension, chronic pancreatic insufficiency secondary to alcohol use and intraductal papillary mucinous neoplasm. Patient underwent a Whipple procedure which was complicated by recurrent gastro-jejunal anastomotic bleeds that improved after EGD with clipping of stomach ulcer and revision of GJ with conversion to Roux-en-Y, ex-lap and wash-out. [...]

Case Presentation: A 66-year-old male with ESRD on dialysis, hepatitis C, hypertension, and opioid use disorder (OUD) on 135 mg of methadone presented with bilateral leg ulcerations and complex pain syndrome that was complicated by recurrent hypoglycemia. His initial blood glucose of 35 was thought to be due to poor insulin clearance with ESRD. He [...]

Case Presentation: A 60-year-old man with a history of alcohol use disorder was admitted to the emergency department due to difficulty moving. The patient was cachectic, agitated, febrile, and tachycardiac. Laboratory results showed hemoglobin 3.2 g/dL, MCV 150.4 fL, WBC 3,300/µL (83% neutrophils, 6.5% lymphocytes), platelets 178,000/µL, LDH 403 U/L, BUN 79.9 mg/dL, creatinine 2.72 [...]

Case Presentation: A 44-year-old paraplegic male with chronic indwelling foley, chronic thoracic back pain, non-occlusive DVT, anemia, insomnia, and depression who presented with a three week history of abdominal pain, bilateral flank pain, chills, and fever was admitted for ESBL UTI. Hospital course was complicated by hypoglycemia and thrombocytosis due to exogenous testosterone use. During [...]