IGF1 and acromegaly: While over the years there have been improvements in the diagnostic procedures for acromegaly, including the availability of serum IGF-1 measurement and more sensitive GH assays, the diagnostic delay and the age at diagnosis have not changed, and that is mostly secondary to the insidious onset of the clinical features, overlap of the signs and symptoms with other common conditions, and lack of disease awareness among other medical specialists [5,7].