IGF1 and Hypoglycemia: As low HbA1c level is associated with increased risk of severe hypoglycemia (19, 20, 21) as is the case in this study, the opposite relationship between HbA1c and IGF1 would have been expected if low IGF1 levels in the nonpregnant patients with diabetes predict severe hypoglycemia as in pregnant women with type 1 diabetes (5).