Case Presentation:             A 64- year- old woman with past medical history of type 1 diabetes mellitus (DM), managed with 22 units of daily subcutaneous long acting insulin, and 50  mg of daily oral canagliflozin, presented to the hospital with new onset nausea and vomiting. Physical examination was notable for Heart [...]

Case Presentation: A 53-year-old man with a history of insulin-dependent type 2 diabetes mellitus presented with the complaint of abdominal pain, emesis and poor oral intake for three days. CT scan revealed non-obstructing nephrolithiasis. He was started on continuous IV fluids and pain management. Initial urinalysis revealed glucosuria >1000 mg/dL and negative ketones. Home medications [...]

Case Presentation: A 61-year-old male with a past medical history of type 2 diabetes mellitus (T2DM), hypertension, hyperlipidemia, coronary artery disease (CAD) with multiple previous PCIs and status post CABG 6 days prior, presented to the ED with a 1 day history of nausea, vomiting, upper abdominal discomfort and chest pain. He was maintained on [...]

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: An 89-year-old year old woman with a history of type II diabetes mellitus, insulin-naïve and well-controlled on a regimen of metformin, sitagliptin, and dapagliflozin, presented with 3 days of nausea, vomiting, and poor intake of food and liquids. She had recently been prescribed cephalexin for a suspected UTI. She reported a subacute history [...]

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 [...]

Case Presentation: A 46-year-old male with a history of type II diabetes mellitus on metformin presented with five days of severe, post-prandial epigastric pain with inability to tolerate meals. Labs on admission were notable for mild hyperglycemia with finger stick blood glucose between 100 and 200 mmol/L with an anion gap of 21, pH 7.3, [...]

Case Presentation: A 46-year-old male with Type 2 DM presented with 2 weeks of malaise, 3 days of cough, dyspnea, and fatigue. His wife noted his breath smelt different over the last 2 weeks. He had a thyroidectomy for multinodular goiter 2 weeks prior and started a ketogenic, intermittent fasting diet after. Medications include empagliflozin [...]

Case Presentation: A 58-year-old man with a history of hypertension, type 2 diabetes with non-adherence to insulin, GERD, and daily alcohol use presented to the emergency department for three days of epigastric abdominal pain and vomiting. He had previously experienced two months of worsening nausea and epigastric fullness with eating accompanied by a 30-pound unintentional [...]

Background: Sodium-glucose transport protein 2 inhibitors (SGLT-2i) are antidiabetic drugs that have shown to aid in all-cause/cardiovascular mortality along with progression of renal disease. ​Though SGLT2i have many benefits, there are many instances where these medications need to be held or discontinued; preoperatively (72h-92h prior to surgery), hypotension, reduced oral intake, decrease in eGFR, urinary [...]