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Inhaled Insulin for Type 2 Diabetes: Solution or Distraction?

David M. Nathan, MD
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Dr. Nathan: Massachusetts General Hospital; Boston, MA 02114

Requests for Single Reprints: David M. Nathan, MD, Massachusetts General Hospital, Diabetes Unit, Bulfinch 408, Fruit Street, Boston, MA 02114.

Ann Intern Med. 2001;134(3):242-244. doi:10.7326/0003-4819-134-3-200102060-00016
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The second most famous “shot heard”—or felt—“round the world” was a 5-mL injection of pancreatic extract given to Leonard Thompson, a 13-year-old patient dying of diabetes, on 23 January 1922 (1). The extract had been prepared by Dr. J.B. Collip on the basis of the seminal work by Banting and Best (2). The insulin, as it came to be called, was relatively dilute—Thompson received 45 mL in the next 36 hours—and caused sterile abscesses. It was administered by using a glass-barreled syringe and probably a 21-gauge needle. Because the only insulin available in those early years was relatively short acting, three to four injections daily were necessary to control glycemia in the asymptomatic range.

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