Overall, DBD may be caused by multiple mechanisms such as hyperglycemia, inflammatory state, insulin and insulin-like growth factor-1 (IGF-1) deficiency, accumulation of AGEs, increased levels of sclerostin and leptin, lower levels of bone formation and bone resorption markers (Vigevano et al. The gene discussed is IGF1; the disease is hyperinsulinemic hypoglycemia, familial, 4.