This study was the first to examine disposal practices and associated risk factors for poor disposal methods among patients in a U.S. tertiary medical center. A large portion of patients was found to have improper sharps disposal practices. Prior formal training in sharps disposal was associated with higher rates of correct practices, suggesting that increased emphasis on provider-patient education can lead to significant improvement in disposal habits.

IMPORTANCEStandard diabetic ketoacidosis care in the US includes intravenous insulin treatment in the intensive care unit. Subcutaneous (SQ) insulin could decrease intensive care unit need, but the data are limited. OBJECTIVE To assess outcomes after implementation of an SQ insulin protocol for treating diabetic ketoacidosis. DESIGN, SETTING, AND PARTICIPANTS This cohort study is a retrospective evaluation of a prospectively implemented SQ insulin protocol. The study was conducted at an integrated health care system in Northern California. Participants included hospitalized patients with diabetic

Hypercalcemia is a rare condition in patients with autoimmune polyglandular syndrome (APS-1), usually characterized by hypoparathyroidism and hypocalcemia, and it can develop due to simultaneous adrenal insufficiency. We present a case of severe hypercalcemia in a patient with APS-1, found to have adrenal insufficiency secondary to steroid non-compliance.

IN BRIEF This article describes a single-center study evaluating hospitalized hyperglycemic patients using the A1C test. Results indicated that A1C measurement may be a useful test for hyperglycemic patients in the inpatient setting.