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Guan X, Rodriguez-Cruz V, Morris ME

Bhutia YD, Babu E, Ramachandran S, Ganapathy V

IGF-1: When to Order This Test and What the Results Mean At a glance IGF-1 is a liver-derived peptide that reflects 24-hour integrated GH secretion Reference range varies by age and sex / typical adult range is 100 to 350 ng/mL Primary indication is suspected GH deficiency or GH excess (acromegaly) Fasting is not required but morning draws improve reproducibility GH-deficient adults show IGF-1 below the age-adjusted lower tertile Acromegaly screening uses IGF-1 plus an oral glucose tolerance test IGF-1 is the preferred monitoring marker during GH peptide therapy (e.g., sermorelin, tesamorelin, CJC-1295/ipamorelin) Malnutrition, liver disease, and uncontrolled diabetes can suppress IGF-1 independent of GH status The Endocrine Society recommends keeping treated IGF-1 within the upper half of the age-adjusted normal range Persistent IGF-1 above the reference ceiling may raise long-term cancer risk What Does IGF-1 Mean

Every diabetes clinic should perform annual screening for DPN to identify the risk of diabetic foot disease using a monofilament and tuning fork (or biothesiometer)