INS and hyperinsulinemic hypoglycemia: If the clinical findings prove hyperinsulinemic hypoglycemia and conventional imaging studies are negative; SACS shows an increased, non-localized insulin response; and/or functional imaging studies suggest diffuse tracer enrichment compatible with a functional β-cell disorder, we think that the clinical diagnosis of a NIPHS is justified, even if the fasting test is positive or hypoglycemia occurs independently of food intake.