It typically manifests as hypoglycemia due to IGF-2-mediated suppression of insulin secretion, and the diagnosis requires fulfillment of Whipple’s triad (7, 8): 1) symptoms consistent with hypoglycemia, 2) documented plasma glucose ≤2.8 mmol/L during symptoms, and 3) symptom resolution following glucose normalization. This evidence concerns the gene INS and Hypoglycemia.