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March 7, 1977

The Primacy of Insulin-Reply

JAMA. 1977;237(10):960. doi:10.1001/jama.1977.03270370031009

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In Reply.—  Our readers will be grateful to Dr Unger for clarifying the bihormonal abnormality hypothesis. Much of the "bias" would have been eliminated from my editorial had "primacy" and "primary" been replaced by more appropriate terms. This, in effect, was done in the first paragraph:Unger's group and others have marshalled experimental evidence to ascribe an essential role to glucagon excess in these homeostatic disturbances.... As a corollary to these experimental findings emerged the concept of diabetes as a bihormonal disorder dependent not only on insulin deficiency but also on glucagon excess.