These changes are most likely caused by hormonal alterations during puberty like an increased growth hormone, a decreased insulin-like growth factor 1 (IGF-1), an increased free androgen index (FAI) higher in diabetics than in control population, lower sex hormone-binding globulin (SHBG), higher body mass index (BMI) in addition to increased an HbA1c level in this period. Here, GH1 is linked to diabetes mellitus.