The mechanisms contributing to hypoglycemia in the 3 case reports differ, ranging from a tiny β-cell neuroendocrine tumor secreting insulin autonomously [2], dysautonomia in Ehlers-Danlos syndrome (EDS) with gastrointestinal (GI) dysmotility and amplify postprandial insulin excursions [3], to a novel heterozygous mutation in the glucokinase (GCK) gene, lowering the glucose threshold for insulin secretion [4]. Here, INS is linked to dysautonomia.