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

Authors
  • Sahakian, Nicolas1
  • Cattieuw, Lauranne1
  • Ramillon-Cury, Clotilde1
  • Corroller, Audrey Bégu-Le1
  • Silvestre-Aillaud, Pascale1
  • Béliard, Sophie1, 2
  • Valéro, René1, 2, 3
  • 1 University Hospital La Conception, 147 boulevard Baille, Marseille, 13005, France , Marseille (France)
  • 2 Aix Marseille Univ, APHM, INSERM, INRAE, C2VN, 27 boulevard Jean Moulin, Marseille, 13005, France , Marseille (France)
  • 3 Centre Hospitalo-Universitaire de La Conception, 147 Boulevard Baille, Marseille, 13005, France , Marseille (France)
Type
Published Article
Journal
Clinical Diabetes and Endocrinology
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jul 20, 2021
Volume
7
Issue
1
Identifiers
DOI: 10.1186/s40842-021-00125-8
Source
Springer Nature
Keywords
Disciplines
  • Case Report
License
Green

Abstract

BackgroundHyperglycemia 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 presentationWe 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.ConclusionsWe 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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