Background: Hyperglycemia is directly associated with increased risk for infection, delayed healing, increased morbidity, mortality and increased length of stay following orthopedic surgery.  A process was developed to identify these patients pre-operatively to proactively intervene before surgery and more aggressively after surgery to control glucose levels. Purpose: Retrospective chart reviews and root cause analysis identified [...]

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 50­ year ­old man with poorly controlled type 2 diabetes mellitus (DM) presented with flank pain, nausea, vomiting, and fever. On exam, he was febrile, tachycardic, hypotensive, and had right sided CVA tenderness. The ER performed a CT stone protocol, however, imaging demonstrated right sided emphysematous pyelonephritis (EPN). Our patient was admitted [...]

Background: Studies have demonstrated that oral medications such as metformin are safe to continue in the hospital, and that when insulin is used in a hospital setting, a basal or basal-bolus regimen is more effective than sliding scale monotherapy (1-2). Despite mounting evidence and society guidelines, clinicians have been slow to adopt these practices in [...]

Background: Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of varying degrees of severity with onset or first recognition during pregnancy (1). In 2013, 6 million women in India were diagnosed with some form of hyperglycemia in pregnancy, of which 90 % were GDM (2). Yoga is an important aerobic activity that may decrease [...]

Background: Hypertension and diabetes are common comorbidities frequently managed by primary care physicians. Poorly controlled cases of these conditions can lead to increased healthcare resource utilization. We conducted a prospective pilot study involving high-risk patients with hypertension and diabetes to evaluate whether a multidisciplinary team approach could lead to improved clinical outcomes and reduced healthcare [...]