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SGLT2 inhibitors as potentially helpful drugs in PI3K inhibitor-induced diabetes: a case report

Abstract : Abstract Background Hyperglycemia is the most common side-effect of phosphatidylinositol 3-kinase (PI3K) inhibitors that are approved for the treatment of some advanced or metastatic breast cancers. This side-effect is likely due to the central role of PI3K in insulin signalling. Here we report the use of a sodium-glucose cotransporter 2 (SGLT2) inhibitor to manage severe hyperglycemia. Case presentation We describe a 74-year-old woman who developed severe uncontrolled hyperglycemia after commencing alpelisib, a new oral PI3K inhibitor indicated for a metastatic breast cancer, despite taking oral anti-diabetic drugs, metformin and vildagliptin, combined with intravenous insulin infusion of up to 250 units/day. The introduction of the SGLT2 inhibitor dapagliflozin rapidly improved blood glucose with a drastic reduction in insulin dosage, from 250 to 12 units/day, and without significant side-effects. Conclusions We report the successful management of hyperglycemia induced by alpelisib using a SGLT2 inhibitor without the need to discontinue effective cancer treatment.
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https://hal-amu.archives-ouvertes.fr/hal-03653403
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Submitted on : Wednesday, April 27, 2022 - 4:56:52 PM
Last modification on : Monday, May 2, 2022 - 3:43:31 PM

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Nicolas Sahakian, Lauranne Cattieuw, Clotilde Ramillon-Cury, Audrey Bégu-Le Corroller, Pascale Silvestre-Aillaud, et al.. SGLT2 inhibitors as potentially helpful drugs in PI3K inhibitor-induced diabetes: a case report. Clinical Diabetes and Endocrinology, 2021, 7 (1), pp.17. ⟨10.1186/s40842-021-00125-8⟩. ⟨hal-03653403⟩

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