It is well recognised that the growth hormone (GH)/insulin-like growth factor (IGF) system is well recognised to have a role in diabetes and obesity. The IGFs (IGF-I and IGF-II) have structural similarity to proinsulin and the type 1 IGF receptors and insulin receptors are able to form heterodimers that participate in metabolic and mitogenic signalling. Obesity, diabetes and the metabolic syndrome are associated with alterations in the GH/IGF system. Perturbations in this system are also associated with predisposition to diabetes, obesity and the metabolic syndrome and also the risk of vascular and other complications.
Targeting this system holds therapeutic promise. Therefore, having introduced the relevant physiology and pathophysiology, the evidence base in to using GH and IGFs in the management of GH and IGFs therapy will be presented and the advantages and limitations of such approaches will be discussed.