Treatment of functional hyperinsulinism in infants varies from the introduction of frequent feeding, through the institution of combined diazoxide/chlorothiazide treatment, to total pancreatectomy in the most refractory cases. In children who respond to conservative treatment, spontaneous recovery is almost invariable during the first ten to fifteen years of life.
In adults, surgical ablation of insulinomas is followed by complete and lasting remission, except in rare malignant insulinomas with hepatic metastases. In such cases palliative therapy, with diazoxide and chlorothiazide, or octreotide, may give prolonged symptomatic relief, as may chemotherapy with streptozotocin, 5-fluorouracil, CCNU, and other antineoplastic agents, with or without hepatic artery embolisation.
