INS and hyperinsulinemic hypoglycemia, familial, 4: Recently, Guevara-Aguirre et al reported on 99 Ecuadorian individuals with Laron syndrome due to growth hormone receptor (GHR) deficiency and congenital insulin-like growth factor-1 (IGF-1) deficiency who did not develop type 2 diabetes (T2D) and were almost free of cancer, in contrast to their healthy relatives with normal insulin/IGF-1 signaling (IIS) [1].