Background: At our urban, academic hospital, use of outdated protocols and unnecessary variations in the care of DKA patients treated with ICU requiring IV insulin protocols have led to multiple safety events, delays in care with associated increased costs, and overtreatment of hyperglycemia with ketosis frequently resulting in unnecessary ICU utilization. After multi-disciplinary stakeholder development [...]

Case Presentation: A 62 YO woman with PMHx significant for type 2 DM, HTN, CAD with a previous MI, and OSA was recovering as expected from elective decompressive laminectomy. On POD 4 she developed nausea, confusion, and lethargy. The hospitalist service was consulted, prompting a metabolic work-up that suggested anion gap metabolic acidosis. There were [...]

Case Presentation: A 54 year-old woman with a past medical history of hypertension and Type 2 diabetes mellitus treated with metformin and canagliflozin presented to the hospital with lethargy and malaise. She reported that her blood glucose was stable over the past 2 weeks with fingerstick glucoses ranging from 100-130mg/ dL. She had been vomiting [...]