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It can range from mild to severe

These responses demonstrate clear biological activity

A study reported that there was no difference in post-prandial plasma incretin concentrations between diffuse and focal cases, and no difference in baseline plasma incretin concentration between focal, diffuse, and transient hyperinsulinism ( Studies in a mouse model of K ATP hyperinsulinism, the most common and severe genetic subtype of hyperinsulinism, have shown that the GLP-1 receptor antagonist exendin-(9-39) significantly increases fasting plasma glucose and decreases the insulin to glucose ratio on the fasting state, effectively reversing the hyperinsulinemic hypoglycemia phenotype

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Contamination risk This is the biggest concern