INS and pituitary deficiency: It is recommended to treat adults with growth hormone deficiency only if they fulfil all three of the following criteria: peak growth hormone response of less than 9 mU/L (3 ng/mL) during an insulin tolerance test or an equivalent test, Quality of Life Assessment of Growth Hormone Deficiency in Adults questionnaire score showing an impaired quality of life, and on treatment for any other pituitary deficiency [59].