Additionally, therapeutic approaches to hyperinsulinemic hypoglycemia in clinical development include the human monoclonal antibody, RZ358 (ersodetug), which acts as a negative allosteric modulator of the insulin receptor, reducing insulin binding, and has been shown to reverse refractory hypoglycemia in a patient with malignant insulinoma (46). This evidence concerns the gene INS and hyperinsulinemic hypoglycemia.