Not to be used if overt diabetes occurs. Increased risk of DM, evidence of glucose intolerance; neoplasms; leukaemia; benign intracranial HTN, GHD secondary to intracranial lesion; incipient hypothyroidism; insulin sensitivity; Ab development. Monitor growth of hands & feet in Turner syndrome patients. Perform otological evaluation annually in girls w/ Turner syndrome. Regularly monitor renal function, signs of scoliosis & thyroid function. Measure fasting insulin & blood glucose prior to & annually thereafter; IGF-I level prior to & twice yrly. Long-term treatment (>10 yr). Not recommended in women of childbearing potential & pregnancy. Lactation. Not recommended in SGA patients near onset of puberty. Childn w/ Prader-Willi & Silver-Russell syndrome. Elderly >60 yr.