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Garry S. Tobin
Washington University in St. Louis
Intensive care medicineInsulinHypoglycemiaDiabetes mellitusMedicine
19Publications
9H-index
326Citations
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Publications 20
Newest
#1Jing Hughes (WashU: Washington University in St. Louis)H-Index: 4
#2Yicheng K. Bao (UMKC: University of Missouri–Kansas City)H-Index: 1
Last. Janet B. McGill (WashU: Washington University in St. Louis)H-Index: 56
view all 12 authors...
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. RESEARCH DESIGN AND METHODS A total of 1,212 adults seen at the Washington University Diabetes Center from 2011 to 2018 provided informed conse...
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#1Michael H. ElliottH-Index: 20
Last. Garry S. TobinH-Index: 9
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Inpatient severe hypoglycemia (SH), blood glucose (BG) This study reflects a retrospective analysis of system-wide data from 2011 to 2017. Results show BG levels post alert are higher on average (mean 92.83) than pre-alert (mean 74.43). This magnitude of difference occurs in each year (pre-post differences range from 14.7 to 19.3), suggesting that the alert system led to a sustained beneficial effect over time. A decreasing trend in SH rate over time was observed, which differed by hospital (Fig...
2 CitationsSource
#1Jeremy Pettus (UCSD: University of California, San Diego)H-Index: 13
#2Dominic N. Reeds (WashU: Washington University in St. Louis)H-Index: 23
Last. Samuel Klein (WashU: Washington University in St. Louis)H-Index: 87
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9 CitationsSource
#1Jing HughesH-Index: 4
#2Brian D. MueggeH-Index: 1
Last. Janet B. McGillH-Index: 56
view all 8 authors...
ABSTRACT 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 w...
1 CitationsSource
#1Paulina Cruz (WashU: Washington University in St. Louis)H-Index: 1
#2Mary Clare Blackburn (WashU: Washington University in St. Louis)H-Index: 2
Last. Garry S. Tobin (WashU: Washington University in St. Louis)H-Index: 9
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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.
1 CitationsSource
#1Dauria T. Wheeler (St. Louis College of Pharmacy)H-Index: 1
#2Stephen J. Schafers (Barnes-Jewish Hospital)H-Index: 5
Last. Garry S. Tobin (WashU: Washington University in St. Louis)H-Index: 9
view all 5 authors...
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. Of the 132 charts randomly selected for review, hypoglycemic events (blood glucose <70 mg/dL) were reduced from 27.3% in the 10-U group to 12.1% in the weight-based grou...
15 CitationsSource
#1C. Rachel Kilpatrick (WashU: Washington University in St. Louis)H-Index: 2
#2Michael B. Elliott (SLU: Saint Louis University)H-Index: 8
Last. Garry S. Tobin (WashU: Washington University in St. Louis)H-Index: 9
view all 9 authors...
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. SETTING Acute care medical floors in a tertiary care academic hospital in St. Louis, Missouri. PATIENTS From 655 in...
12 CitationsSource
#1Eli N. Deal (Barnes-Jewish Hospital)H-Index: 10
#2Garry S. Tobin (WashU: Washington University in St. Louis)H-Index: 9
Last. Janet B. McGill (WashU: Washington University in St. Louis)H-Index: 56
view all 3 authors...
Serious hyperglycemia, defined as blood glucose (BG) greater than 300 mg/dL, is a common occurrence in hospitalized patients, and can be challenging to manage. Subcutaneous insulin may provide less desirable pharmacokinetics in these urgent situations and intravenous continuous infusions present a significant safety concern in areas with less nursing coverage. Regular insulin given intravenously as a bolus dose offers a unique advantage in treating these urgent elevations in BG due to its quick ...
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#1Garry S. Tobin (WashU: Washington University in St. Louis)H-Index: 9
#2M. K. Cavaghan (IUPUI: Indiana University – Purdue University Indianapolis)H-Index: 1
Last. Janet B. McGill (WashU: Washington University in St. Louis)H-Index: 56
view all 4 authors...
Summary Background: Type 2 diabetes is a progressive disease that requires stepwise additions of non-insulin and insulin therapies to meet recommended glycaemic goals. The final stage of intensification may require prandial insulin, adding complexity and increased risks of hypoglycaemia and weight gain. Aims: This review assesses the benefits and risks of adding exenatide twice daily, a glucagon-like peptide 1 receptor agonist, in patients with type 2 diabetes who are currently treated with basa...
10 CitationsSource
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