IGFBP1 and Insulin resistance: Although only nighttime GH/IGF-1 axis activity was assessed in our study, daytime GH/IGF-1 axis activity mimics nighttime GH/IGF-1 axis activity and increases insulin resistance and exogenous insulin requirements in adolescent girls with T1DM.(34) The significantly lower postmeal IGF-1 and higher IGFBP-1/IGF1 levels in the T1DM cohort also suggest that GH/IGF-1 axis activity remains altered throughout the day.