Pregnancy complicated by insulinoma

Gestational hypoglycemia may result from either reactive hypoglycemia or complications related to the pregnancy. We report a 19-year-old pregnant patient with insulinoma who was treated successfully by distal pancreatectomy during the first trimester. A high index of suspicion was required for the diagnosis since abnormal immunoreactive insulin (IRI) and glucose (G) ratios (I/G) greater than 0.3 can be found in non-insulinoma normal pregnancy. The incidence of insulinoma complicating pregnancy is unknown, but it is important since gestational hypoglycemia can be associated with an increased perinatal mortality and morbidity similar to that of gestational hyperglycemia.