During inpatient supervised fasting, symptomatic hypoglycemia was recorded at 4 hours with a venous plasma glucose of 39 mg/dL (2.2 mmol/L) and paired immunoassay plasma insulin and C-peptide concentrations of 17,800 and 409 pmol/L, respectively, with an insulin to C-peptide molar ratio of 44 (NR 0.03 to 0.25). Here, INS is linked to Hypoglycemia.