All of these findings suggest that in type 2 diabetes, during aging, there is a premature and progressive decline in serum IGF-I bioactivity, resulting in the development of a progressive (relative) IGF-I deficiency, especially in those with poor metabolic control, which can cause vascular damage and vascular dysfunction. The gene discussed is IGF1; the disease is hyperinsulinemic hypoglycemia, familial, 4.