We report a case of a patient with chronic pancreatitis secondary to heterozygous SPINK1/CFTR gene pathogenic variants who was managed with TPIAT achieving insulin independence, but 4 months later developed spontaneous severe hypoglycemia with loss of consciousness, which was refractory to conventional treatment but effectively managed with liraglutide and dietary manipulation. The gene discussed is INS; the disease is Hypoglycemia.