The treatment of hyperinsulinemic hypoglycaemia in adults: an update.
BACKGROUND
Treatment of hyperinsulinemic hypoglycaemia (HH) is challenging due to the rarity of this condition and the difficulty of differential diagnosis. The aim of this article is to give an overview of the recent literature on the management of adult HH.


METHODS
A search for reviews, original articles, original case reports between 1995 and 2016 in PubMed using the following keywords: hyperinsulinemic hypoglycaemia, insulinoma, nesidioblastosis, gastric bypass, autoimmune hypoglycaemia, hyperinsulinism, treatment was performed.


RESULTS
One hundred and forty articles were selected and analysed focusing on the most recent treatments of HH.


CONCLUSIONS
New approaches to treatment of HH are available including mini-invasive surgical techniques and alternative local-regional ablative therapy for benign insulinoma and everolimus for malignant insulinoma. A correct differential diagnosis is of paramount importance to avoid unnecessary surgical operations and to implement the appropriate treatment mainly in the uncommon forms of HH, such as nesidioblastosis and autoimmune hypoglycaemia.
Section of Endocrinology, Medicina Generale e Malattie Aterotrombotiche e Degenerative, Department of Medicine, University of Verona, Piazzale LA Scuro, Policlinico G.B. Rossi, 37134, Verona, Italy. mariavittoria.davi@ospedaleuniverona.it.
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Davi
Internal Medicine I, Department of Clinical and Biological Sciences, University of Turin, San Luigi Hospital, Orbassano, Italy.
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Pia
Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Palermo, Italy.
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Guarnotta
Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
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Pizza
Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
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Colao
Thyroid and Parathyroid Surgery Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy.
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Faggiano
D000328:Adult; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications / Q000628:therapy*; D007003:Hypoglycemia / Q000150:complications / Q000628:therapy*
Autoimmune hypoglycaemia; Hyperinsulinemic hypoglycaemia; Insulinoma; Nesidioblastosis; Treatment