Treatment of hyperinsulinism after partial pancreatectomy: medical or surgical?

A 21 year old male patient with hypoglycemia secondary to hyperinsulinism had no palpable adenoma at surgery, and failed to respond to a partial (75%) pancreatectomy. Subsequently, he was begun on oral Diazoxide. Soon after initiation of Diazoxide he developed a viral pneumonitis, and because of hyperglycemia, the Diazoxide was temporarily discontinued. He has been treated since June of 1975 with Diazoxide, 100 mg, three times daily. He is asymptomatic, completely rehabilitated, and physically active at work for 10 hours daily. Diazoxide therapy may be an option worth considering even in benign states of hyperinsulinism when surgery has failed to correct the process.