Most children with focal hyperinsulinism are cured after surgical excision of the lesion; however, almost half of children with diffuse hyperinsulinism have persistent hypoglycemia after near-total pancreatectomy. A comprehensive assessment of the glycemic status should be undertaken once the patient is on a stable feeding regimen for several days. This assessment includes performing a Cure Fast to demonstrate the resolution of hyperinsulinism in children with focal hyperinsulinism, evaluation for the possibility of post-pancreatectomy diabetes after near-total pancreatectomy, and assessment for persistent hypoglycemia in children with diffuse hyperinsulinism. Treatment of persistent hyperinsulinism following pancreatectomy requires an individualized approach and often requires a combination of therapies to achieve a suitable regimen that can safely and reasonably be carried out at home.
Ackermann, A. M., & De León-Crutchlow, D. D. (2019). Management of the child with persistent hypoglycemia after surgery. In Contemporary Endocrinology (pp. 119–130). Humana Press Inc. https://doi.org/10.1007/978-3-030-02961-6_11