INS and microcephaly: All had severe microcephaly (median standard deviation score –6.2, IQR –6.5 to 6.1; Supplemental Figure 1B), epilepsy diagnosed in the neonatal period (range 1–7 months), and neonatal/early-onset diabetes (age at diagnosis range 4 weeks to 20 months) that was treated with a full replacement dose of insulin.