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## Mometrix ### Symptoms include: - Blood glucose < 40 mg/dL - Central nervous system: seizures, altered consciousness, lethargy, and poor feeding with vomiting, myoclonus, respiratory distress, diaphoresis, hypothermia, and cyanosis. ### Treatment includes: - Glucose/Glucagon administration to el...

## Mometrix ### Symptoms include: - Blood glucose < 40 mg/dL - Central nervous system: seizures, altered consciousness, lethargy, and poor feeding with vomiting, myoclonus, respiratory distress, diaphoresis, hypothermia, and cyanosis. ### Treatment includes: - Glucose/Glucagon administration to elevate blood glucose levels. - Diazoxide (Hyperstat®) inhibits release of insulin. - Somatostatin (Sandostatin®) to suppress insulin production. - Nifedipine. - Surgical removal of 85-90% of pancreas may be needed for infants to reduce insulin but poses a risk of diabetes. ### Different types of insulin: There are a number of different types of insulin with varying action times. Insulin is used to metabolize glucose for those whose pancreases do not produce insulin. People may need to take a combination of insulin's (short and long-acting) to maintain glucose control. Duration of action may vary according to the individual's metabolism, intake, and level of activity: - Humalog (Lispro H) is a fast-acting, short-duration insulin that acts within 5-15 minutes, peaking between 45-90 minutes and lasting 3-4 hours. - Regular (R) is a relatively fast-acting, 30-minute insulin that peaks in 2-5 hours and lasts 5-8 hours. - NPH (N) or Lente (L)) insulin is intermediate-acting with onset in 1-3 hours, peaking at 6-12 hours and lasting 16-24 hours. - Ultralente (U) is long-acting insulin with onset in 4-6 hours, peaking at 8-20 hours, and lasting 24-28 hours. - Combined NPH/Regular (70/30 or 50/50) has an onset of 30 minutes, peaks at 7-12 hours, and lasts 16-24 hours. ### Nephrotic syndrome: Nephrotic syndrome is not a specific disease but a syndrome of disorders that include excessive proteinuria, generalized edema, hypoalbuminemia, hypoproteinemia, depressed immune response, and hyperlipidemia. Two types of nephrotic syndrome are congenital (10%) and primary (90%). With most primary disease associated with minimal change nephrotic syndrome (MCNS). MCNS (meaning there is minimal change in the appearance of glomeruli) occurs primarily in children between 2 and 7, more commonly boys, and is responsive to steroids. The cause of MCNS is not clear, but it is usually preceded by an upper respiratory infection. Ninety percent respond well to treatment; however, about 70% of children successfully treated experience relapse of symptoms, usually associated with respiratory infection or live virus immunization. Relapses become less frequent during adolescence but may continue into adulthood. Additionally, MCNS can progress to acute renal failure or chronic renal failure and end-stage renal disease, especially in children of African American or Hispanic ethnicity.