Aust Fam Physician
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Primary nocturnal enuresis is common, and if left untreated has considerable psychological ramifications on children as they get older. ⋯ By far the most successful treatment is the bed wetting alarm. In recent years desmopressin nasal spray has also found a clinical niche as a short term solution for children attending school camps or sleeping over at friends' houses. It may also be used as an adjunct to the use of the alarm. Treatment with imipramine is increasingly in disfavour because the relapse rate is unacceptably high and fatal overdose is a possibility.
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Type 2 diabetes mellitus is a major and increasing cause of morbidity and early mortality among the Aboriginal population of northern Australia. Due to differing social, dietary and probably metabolic factors, management needs differ from the mainstream Australian diabetic population. ⋯ In the abscence of specific contraindications, and in variance with some present guidelines, the evidence suggests that initial therapy with metformin rather than the sulphonylureas is likely to provide greater clinical benefit, and have a greater margin of safety.