diff --git a/sqlite_utils/db.py b/sqlite_utils/db.py
index c48483d..9ac8e23 100644
--- a/sqlite_utils/db.py
+++ b/sqlite_utils/db.py
@@ -224,6 +224,8 @@ class Database:
         single_pk = None
         if isinstance(pk, str):
             single_pk = pk
+            if pk not in [c[0] for c in column_items]:
+                column_items.insert(0, (pk, int))
         for column_name, column_type in column_items:
             column_extras = []
             if column_name == single_pk:
diff --git a/tests/test_create.py b/tests/test_create.py
index 288a8ee..222a967 100644
--- a/tests/test_create.py
+++ b/tests/test_create.py
@@ -734,3 +734,8 @@ def test_cannot_provide_both_filename_and_memory():
         AssertionError, match="Either specify a filename_or_conn or pass memory=True"
     ):
         Database("/tmp/foo.db", memory=True)
+
+
+def test_creates_id_column(fresh_db):
+    last_pk = fresh_db.table("cats", pk="id").insert({"name": "barry"}).last_pk
+    assert [{"name": "barry", "id": last_pk}] == list(fresh_db["cats"].rows)