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The Ecuadorian Laron and Brazilian Itabaianinha cohorts with congenital mutations in the GH and GHRH receptors, respectively, both provide a unique and arguably the purest examples to evaluate the effects of chronic severe IGF-I and both severe GH and IGF-I deficiency, respectively, with severe hypoinsulinemia being the common denominator in both cohorts (151, 152) ( Table 1

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Reducing the dose and administering it with meals will minimize these effects in the sensitive patient

6th International Workshop on the Molecular Biology of Stress Responses, March 25-29, 2008, Bangkok, Thailand Hurwitz, D., Zheng, H., Nagaraja, G.M., Bausero, M.A., Manola, J., Kaur, P., Asea, A

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