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

Clinical Diabetes and Endocrinology Pub Date : 2021-07-20 DOI:10.1186/s40842-021-00125-8

Nicolas Sahakian, Lauranne Cattieuw, Clotilde Ramillon-Cury, Audrey Bégu-Le Corroller, Pascale Silvestre-Aillaud, Sophie Béliard, René Valéro

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引用次数: 9

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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SGLT2抑制剂作为PI3K抑制剂诱导的糖尿病的潜在有用药物:1例报告

背景:高血糖是磷脂酰肌醇3-激酶(PI3K)抑制剂最常见的副作用，已被批准用于治疗一些晚期或转移性乳腺癌。这种副作用可能是由于PI3K在胰岛素信号传导中的核心作用。在这里，我们报告使用钠-葡萄糖共转运蛋白2 (SGLT2)抑制剂来治疗严重的高血糖。病例介绍:我们描述了一名74岁的女性，尽管服用口服降糖药二甲双胍和维格列汀，并静脉注射高达250单位/天的胰岛素，但她在开始使用alpelisib(一种用于转移性乳腺癌的新型口服PI3K抑制剂)后出现了严重的不受控制的高血糖。SGLT2抑制剂dapagliflozin的引入迅速改善了血糖，胰岛素剂量从250单位/天急剧减少到12单位/天，并且没有明显的副作用。结论:我们报告了使用SGLT2抑制剂成功管理alpelisib诱导的高血糖，而无需停止有效的癌症治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Diabetes and Endocrinology

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： Clinical Diabetes and Endocrinology is an open access journal publishing within the field of diabetes and endocrine disease. The journal aims to provide a widely available resource for people working within the field of diabetes and endocrinology, in order to improve the care of people affected by these conditions. The audience includes, but is not limited to, physicians, researchers, nurses, nutritionists, pharmacists, podiatrists, psychologists, epidemiologists, exercise physiologists and health care researchers. Research articles include patient-based research (clinical trials, clinical studies, and others), translational research (translation of basic science to clinical practice, translation of clinical practice to policy and others), as well as epidemiology and health care research. Clinical articles include case reports, case seminars, consensus statements, clinical practice guidelines and evidence-based medicine. Only articles considered to contribute new knowledge to the field will be considered for publication.