There was a higher prevalence of shoe size increase: (43% vs 11%; p = 0.027) paresthesia (71% vs 28%; p = 0.023), hoarse voice (57 vs 18%; p = 0.021) arthralgia (100% vs 47%; p = 0.005) and diabetes (71% vs 15%; p = 0.001) in patients with persistently elevated IGF-1. The gene discussed is IGF1; the disease is diabetes mellitus.