Endogenous hyperinsulinemic hypoglycemia in pregnancy: Challenges in management and review of literature

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.