INS and hyperinsulinism: An important role for the HIF-pathway as the signal for lower KATP-channel trafficking and lower glucose threshold for insulin secretion is also indicated by the clinical observation that many of the conditions associated with perinatal-stress related hyperinsulinism involve hypoxia and/or reduced placental circulation (maternal toxemia, erythroblastosis fetalis, birth asphyxia, intrauterine growth retardation, etc) (18, 20).