Most patients with hypoglycemia (78%) were managed with non-pharmacological interventions (dietary, continuous glucose monitoring); pharmacologic therapies included acarbose (22%), diazoxide (13%), and minidose glucagon (7%).<h4>Conclusions</h4>Spontaneous hypoglycemia is a frequent, clinically relevant complication among insulin-independent TPIAT recipients. This evidence concerns the gene GCG and Hypoglycemia.