POMC and Hypoglycemia: Paradoxically, despite hypoglycemia typically stimulating counter-regulatory hormones such as cortisol, GH, and IGF-1 (12), this patient exhibited subnormal cortisol (307.95 nmol/L) with elevated ACTH (60.14 pg/mL), suppressed GH (0.52 ng/mL), and IGF-1 (26.47 ng/mL).