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Nasal-Spray Medication for Diabetics

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Question: Is there any possibility that the insulin nasal spray for diabetics will ever replace insulin injections? Doctors complain that patients don’t follow their instructions, but I’d be willing to bet that patients would use the nasal spray more conscientiously. I would also like to know if the insulin in the spray is the same as that used for injections.

Answer: The results of various studies indicate that the insulin nasal spray can be as effective as insulin injections. However, you should know that the spray is not designed to replace injections, but to supplement them.

The insulin that is used as a nasal spray is mixed with an agent that permits it to be absorbed by nasal tissue. The insulin used for injections is not absorbed in this fashion.

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Q: I’ve read in your column about how children should not be given tetracycline because it could discolor their teeth. Is it possible to avoid this by giving them only a small dose and for only a short period of time? Does tetracycline have any other side effects besides discoloring the teeth?

A: Tetracycline should be used for children only when no other suitable drug is available. It can be deposited in the skeleton and may therefore impair bone growth in addition to staining the teeth of children younger than 8. The degree to which such staining may occur cannot be predicted by the dosage prescribed or by the length of treatment.

Tetracycline may cause similar adverse effects in the children of pregnant women who use it.

Q: I am 15 and I would like to know if when a girl starts to menstruate, whether that means she can become pregnant.

A: The onset of menstruation and the ability to conceive do not necessarily occur a the same time. It has been estimated that during the first year following the initiation of menstruation, more than one-half the cycles do not involve ovulation. Regular, monthly ovulation generally does not occur until about age 19 or 20.

Q: Is it possible for a mother who has the AIDS virus to breast-feed her baby?

A: Breast milk may be a source of transmission of the human immunodeficiency virus (HIV). Therefore it is recommended that HIV-infected mothers not breast-feed their infants. The actual risk of such transmission, however, is not known.

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