A special FDA importation process is required to obtain bovine or porcine derived insulin for use in the U.S., although there may be some remaining stocks of porcine insulin made by Lilly in 2005 or earlier, and porcine lente insulin is also sold and marketed under the brand name Vetsulin(SM) in the U.S. for veterinary usage in the treatment of companion animals with diabetes. Basal insulin
In type 1 diabetes, insulin production is extremely low, and as such the body requires exogenous insulin. Some people with type 2 diabetes, particularly those with very high hemoglobin A1c values, may also require a baseline rate of insulin, as their body is desensitized to the level of insulin being produced. Basal insulin regulates the bodys blood glucose between mealtimes, as well as overnight. This basal rate of insulin action is generally achieved via the use of an intermediate-acting insulin (such as NPH) or a long-acting insulin analog. In type 1 diabetics, it may also be achieved via continuous infusion of rapid-acting insulin using an insulin pump. Approximately half of a persons daily insulin requirement is administered as a basal insulin, usually administered once per day at night. Prandial insulin
When a person eats food containing carbohydrates and glucose, insulin helps regulate the bodys metabolism of the food. Prandial insulin, also called mealtime or bolus insulin, is designed as a bolus dose of insulin prior to a meal to regulate the spike in blood glucose that occurs following a meal.
Prognosis
The prognosis of ectopia cordis depends on classification according to three factors:
Location of the defect
Cervical
Thoracic
Thoracoabdominal
Abdominal
Extent of the cardiac displacement
Presence or absence of intracardiac defectsSome studies have suggested a better prognosis with surgery in cases of thoracoabdominal ectopia cordis or less severe pentalogy of Cantrell. In general, the prognosis for ectopia cordis is poor—most cases result in death shortly after birth due to infection, hypoxemia, or cardiac failure. Epidemiology
The occurrence of ectopia cordis is 8 per million births. It is typically classified according to location of the ectopic heart, which includes:

Cervical
Thoracic
Thoracoabdominal
AbdominalThoracic and thoraco-abdominal ectopia cordis constitute the vast majority of known cases. References


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