Inclusion criteria
re-testingAbility
INSULIN TOLERANCE, EVENT

Children aged 8–15 years of age (inclusive) for females and 9–17 years of age (inclusive) for males with reversed I-GHD (peak GH ≥ 6.7 μg/L using arginine or insulin tolerance test and a serum IGF-1 within normal reference range for sex and age), normal brain MRI (including small anterior pituitary) and in established puberty (Tanner stages B2/3 in girls and 6–12 ml testes* in boys (as measured by orchidometer**)The initial diagnosis of I-GHD will have been made by either two GH stimulation tests (peak GH < 6.7 μg/L) or one stimulation test (peak GH < 6.7 μg/L) with IGF-1 below normal range for sex and age (< -2SDS) irrespective of sex-hormone priming for GH stimulation testsChildren will have discontinued GH treatment for a minimum of 6 weeks prior to re-testingAbility to tolerate the administration of GH therapyAbility to comply with trial schedule and follow-upWritten informed consent obtained from the patient’s parent/guardian and written assent obtained from patient (where age appropriate). In the UK, patients aged 16 years or older will provide their own written informed consent.*In the event of discrepancy between the size of an individual’s testicles, the larger testicle should be used.**In the event that the size of a patient’s testicle falls between the measuring beads of the orchidometer and it is not clear which bead the testicle is most similar to, the larger bead should be used.