I don't think that hyperinsulinism co-occurs with type two diabetes. I strongly suspect that both my mother and I have the disorder. My reasoning is this: I am 19 years old and have been symptomatic of hyperinsulinism since birth, and my mother is in her 50s and is still not showing signs of adult-onset diabetes. Furthermore, the tired pancreas theory (I've heard it from plenty of others) does not explain why babies and young children have hyperinsulinism--what metabolic abuse could they have possibly done to their bodies in their short lives to ruin the organ's function?
Hyperinsulinism is not typically a problem in which the cells do not recognize glucose (and hence there is a perceived "need" for more insulin to stimulate uptake) but one in which the insulin-producing cells do not know to take a break when the concentration of glucose in the bloodstream decreases. As fast as glucose is put into the bloodstream (from eating, breakdown of stored energy material, etc.), it is shoveled into the cells, resulting in a perpetually low level of blood glucose. If all the glucose is absorbed before most of it is circulated to the brain, nervous symptoms (lightheadedness, dizziness) resulting from hypoglycemic episodes may result. There are other symptoms (rapid breathing, sweating, elevated heart rate, nervousness) caused by epinephrine, which mobilizes stored energy as though a survival crisis is imminent. Ask anyone in the middle of an "attack": do not stand between that person and food, or a crisis will happen!