In New Zealands early colonial history, so many settlers died while trying to cross the rivers that drowning was called "the New Zealand death. "People have drowned in as little as 30 mm (1.2 in) of water while lying face down. Children have drowned in baths, buckets, and toilets. People who are inebriated or otherwise intoxicated can drown in puddles. Death can occur due to complications following an initial drowning. Inhaled fluid can act as an irritant inside the lungs. Even small quantities can cause the extrusion of liquid into the lungs (pulmonary edema) over the following hours; this reduces the ability to exchange the air and can lead to a person "drowning in their own body fluid." Vomit and certain poisonous vapors or gases (as in chemical warfare) can have a similar effect. The reaction can take place up to 72 hours after the initial incident and may lead to a serious injury or death. Risk factors
Many behavioral and physical factors are related to drowning:
Drowning is the most common cause of death for people with seizure disorders, largely in bathtubs. Epileptics are more likely to die due to accidents such as drowning. However, this risk is especially elevated in low- and middle-income countries compared to high-income countries. The use of alcohol increases the risk of drowning across developed and developing nations. Alcohol is involved in approximately 50% of fatal drownings, and 35% of non-fatal drownings. Inability to swim can lead to drowning. Participation in formal swimming lessons can reduce this risk.
A variety of pre-operative diagnostic procedures have been investigated but none has been established as infallibly reliable. Positron emission tomography is becoming the most useful imaging technique. Differential diagnosis
The differential diagnosis of congenital hyperinsulinism is consistent with PMM2-CDG, as well as several syndromes. Among other diagnoses, the following are listed:
MPI-CDG
Beckwith-Wiedemann syndrome
Sotos syndrome
Usher 1 syndromes

Types
Congenital hyperinsulinism has two types, diffuse and focal, as indicated below:

Treatment
In terms of treatment, acute hypoglycemia is reversed by raising the blood glucose, but in most forms of congenital hyperinsulinism hypoglycemia recurs and the therapeutic effort is directed toward preventing falls and maintaining a certain glucose level. Some of the following measures are often tried:

Corn starch can be used in feeding; unexpected interruptions of continuous feeding regimens can result in sudden hypoglycemia, gastrostomy tube insertion (requires a minor surgical procedure) is used for such feeding. Prolonged glucocorticoid use incurs the many unpleasant side effects of Cushings syndrome, while diazoxide can cause fluid retention requiring concomitant use of a diuretic, and prolonged use causes hypertrichosis. Diazoxide works by opening the KATP channels of the beta cells. Octreotide must be given by injection several times a day or a subcutaneous pump must be inserted every few days, octreotide can cause abdominal discomfort and responsiveness to octreotide often wanes over time. Glucagon requires continuous intravenous infusion, and has a very short half-life.Nifedipine is effective only in a minority, and dose is often limited by hypotension.