GH1 and hypopituitarism: Although the cause of HY in hypopituitarism is still debated, it is known that GH and cortisol, in physiologic doses, act synergistically to elevate the blood glucose, and that the replacement of both hormones is necessary to normalize insulin secretion and maintain normal glucose homeostasis in children with hypopituitarism; probably GHD is responsible of HY because of loss of amino acid mobilization to support gluconeogenesis (63, 64).