Demographic, clinical, surgical, and metabolic variables were evaluated, and treatment strategies were reviewed.<h4>Results</h4>Among 503 TPIAT recipients, 156 (31%) achieved insulin independence; of these, 45 (28.8%) experienced hypoglycemia, including 32 (20.5%) with level 2 hypoglycemia (< 54 mg/dL). Here, INS is linked to Hypoglycemia.