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Case Report
Endogenous hyperinsulinemic hypoglycemia in pregnancy: Challenges in management and review of literature
1 Consultant Obstetrician and Gynaecologist, Barts Health NHS Trust, Newham University Hospital, Glen Road, London E13 8SL, UK
2 Consultant Anaesthetist, West Hertfordshire Teaching Hospital, Vicarage Road, Watford, WD18 0HB, UK
3 Consultant Obstetrician and Gynaecologist, Foundation Trust, North Middlesex University Hospital, Sterling Way, London N18 1QX, UK
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Elizabeth Ande
Consultant Obstetrician and Gynaecologist, Barts Health NHS Trust, Newham University Hospital, Glen Road, London E13 8SL,
UK
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Article ID: 100238Z08EA2026
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How to cite this article
Ande E, Tharmalingam B, Govind A. Endogenous hyperinsulinemic hypoglycemia in pregnancy: Challenges in management and review of literature. J Case Rep Images Obstet Gynecol 2026;12(2):19–24.ABSTRACT
This case report describes a patient in her early twenties, with postprandial hyperinsulinemic hypoglycemia (HH) in pregnancy. She was diagnosed in childhood and was cared for by a multidisciplinary team in a tertiary facility. She then transferred to a secondary institution, as part of the transition from pediatrics to adult care. Her pregnancy was complicated by multiple episodes of hypoglycemic seizures, warranting multidisciplinary management and in-patient admission. She was commenced on Acarbose and Fortisip, as Cornstarch which she had used in the past, was not effective in controlling the hypoglycemic episodes during the pregnancy. She was delivered via Cesarean section at 34 weeks of gestation. The management of HH can be difficult and this was complicated by the pregnancy. The authors share the challenges of managing this condition in pregnancy together with a review of the literature.
Keywords: Endogenous hyperinsulinemic hypoglycemia, Nesidioblastosis, Octreotide, Pregnancy
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Author Contributions
Elizabeth Ande - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Bhamini Tharmalingam - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Abha Govind - Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2026 Elizabeth Ande et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
