Late-Onset T1DM and Older Age Predict Risk of Additional Autoimmune Disease.

Objective: Type 1 diabetes (T1DM) is associated with other autoimmune diseases (AIDs), which may have serious health consequences. The epidemiology of AIDs in T1DM is not well defined in adults with T1DM. In this cross-sectional cohort study, we sought to characterize the incident ages and prevalence of AIDs in adults with T1DM across a wide age spectrum.

Effect of a glucagon receptor antibody (REMD-477) in type 1 diabetes: A randomized controlled trial.

The aim of the current study (Clinical trial reg. no. NCT02715193, clinicaltrials.

HIGH-RISK GASTRIC PATHOLOGY AND PREVALENT AUTOIMMUNE DISEASES IN PATIENTS WITH PERNICIOUS ANEMIA.

Objective: Pernicious anemia (PA) develops from atrophic gastritis due to autoimmune destruction of parietal cells and results in achlorhydria, vitamin B12 and iron deficiencies, anemia, neurologic deficits, and premalignant and malignant stomach lesions. We report the presentation, diagnosis and gastric complications of PA in patients from an endocrinology practice.

Methods: Thirty-four patients (31 female, 3 male) with PA who underwent esophagogastroduodenoscopy (EGD) or gastrectomy were identified.

A Systematic Approach for the Prevention and Reduction of Hypoglycemia in Hospitalized Patients.

Purpose Of Review: Hypoglycemia and severe hypoglycemia (SH) in the inpatient setting are associated with poor outcomes. This review is designed to highlight approaches to predict and prevent inpatient hypoglycemia that has been successfully implemented focusing on developing overlapping policies and procedures that allow safe glycemic management to occur at all levels of the institution.

Recent Findings: Standardizing point-of-care (POC) testing, nursing protocols, meal delivery, and formulary restriction are useful tools to prevent hypoglycemia.

Improving Diabetes Care with Technology and Information Management.

Patients and physicians in the 21 century require new tools to manage the growing burden of chronic illness. For providers responsible for the care of diabetic patients, developments in information management, real-time health education and feedback, and new approaches to self-monitoring and insulin delivery hold great promise to improve the quality and safety of diabetes care. This article will briefly highlight some of the major developments in the field, and the ways these technologies can be integrated into a typical practice.

Weight-based insulin dosing for acute hyperkalemia results in less hypoglycemia.

Hyperkalemia treatment with intravenous insulin has been associated with hypoglycemia. This single-center, retrospective study compared the effects on hypoglycemia between weight-based insulin dosing (0.1 U/kg of body weight up to a maximum of 10 U) compared to standard flat doses of 10 U among patients weighing less than 95 kg.

Prevention of inpatient hypoglycemia with a real-time informatics alert.

Background: Severe hypoglycemia (SH), defined as a blood glucose (BG) <40 mg/dL, is associated with an increased risk of adverse clinical outcomes in inpatients.

Objective: To determine whether a predictive informatics hypoglycemia risk-alert supported by trained nurse responders would reduce the incidence of SH in our hospital.

Design: A 5-month prospective cohort intervention study.

Prediction and prevention of treatment-related inpatient hypoglycemia.

Background: Prolonged severe hypoglycemia (SH) in hospitalized patients is associated with increased morbidity and mortality. This study was undertaken to identify risk factors for SH, to apply that knowledge to the development of a prediction algorithm, and to institute a prevention program at a tertiary medical center.

Methods: We analyzed SH events for 172 patients and developed computer algorithms to predict SH that were tested on a population of 3028 inpatients who were found to have blood glucose (BG) <90 mg/dl during their hospital stay.

Incidence of hypoglycemia following insulin-based acute stabilization of hyperkalemia treatment.

Purpose: The aim of this study was to assess the incidence of hypoglycemia in hospitalized patients following acute treatment of hyperkalemia with insulin. A characterization of the affected patients and the administered insulin/dextrose regimens was also performed.

Methods: A retrospective search of the electronic records of a large university-based tertiary care hospital was conducted, from June 1, 2009 to December 1, 2009, to identify patients who developed hypoglycemia following acute stabilization of hyperkalemia treatment with regular insulin.

Inpatient insulin orders: are patients getting what is prescribed?

Background: In-hospital insulin administration is associated with many medication errors, but the frequency and reasons for insulin administration errors are poorly described. To document types and frequency of errors related to insulin administration, an examination of 4 units was conducted.

Methods: Using snapshot methodology, 4 non-intensive care unit (ICU) areas (medicine, cardiology, transplant, and surgery) were examined in an observational, prospective manner for 4 weeks.

Preventing hypoglycemia with novel technology and flexible therapy.

Diabetes is increasing at an alarming rate. Treatment-associated hypoglycemia is a major limitation to achieving glycemic control in diabetes. Appropriate use of new technology and flexible treatment regimens, especially in those with defined risk factors, may decrease the frequency of hypoglycemia.

A case of severe neuropathy associated with hypertriglyceridemia.

Objective: To describe a case of severe neuropathy associated with hypertriglyceridemia.

Methods: We describe the clinical and laboratory findings of the study patient and review the relevant literature.

Results: A 45-year-old woman presented to the emergency department with recurrent abdominal pain and severe peripheral neuropathy.

Inpatient glycemic control on the vascular surgery service.

Objective: To describe a structured inpatient insulin management protocol and order set for glycemic control on a vascular surgery service.

Methods: Patients admitted to the vascular surgery service with underlying diabetes were enrolled in a study of use of a preprinted basal-bolus insulin order set based on a total daily dose of 0.5 U/kg (0.