Our last specific question related to the risks (e.g. tumours, hypoglycemia, cardiac hypertrophy, other soft tissue overgrowth) and benefits (assessed by A1c) of recombinant human IGF-1 (rhIGF-1) or IGF-1/IGFBP3 composite in patients with pathogenic INSR variants. Here, IGF1 is linked to cardiac hypertrophy.