We report the case of a 45-year-old woman with metastatic breast cancer who started treatment with alpelisib nine days before developing diabetic ketoacidosis (DKA). At the time of DKA diagnosis, blood tests showed a capillary blood glucose of 30 mmol/L, serum carbon dioxide level of 11 mmol/L, an anion gap of 25 mEq/L, and a glycated hemoglobin A1C (HbA1c) level of 6.4% (50 mmol/mol). Her HbA1C on admission was 5.6% (38 mmol/mol). Capillary blood glucose levels improved upon discontinuation of alpelisib and returned to baseline four days after drug discontinuation. DKA is a rare but serious adverse effect of alpelisib. Patients on this medication should be closely monitored for hyperglycemia and DKA. Further studies are needed to help identify patients at risk of hyperglycemia and DKA.
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http://dx.doi.org/10.7759/cureus.20817 | DOI Listing |
Expert Opin Pharmacother
January 2025
The Association of Diabetes Investigators, California, CA, USA.
Introduction: Type 1 diabetes is a unique autoimmune attack on the β cell of the pancreatic islet resulting in progressive destruction of these cells and as a result the ability of the body to maintain insulin production. The consequences of insulin deficiency are very severe, and the disease was fatal prior to the ability to extract insulin from animal pancreas in 1921. We review progress in the treatment of childhood type 1 diabetes over the past 100 years.
View Article and Find Full Text PDFFront Oncol
January 2025
Department of Radiology, People's Hospital of Deyang City, Deyang, Sichuan, China.
Inflammatory myofibroblastic tumors (IMTs) are rare mesenchymal neoplasms with intermediate biological potential and are characterized by spindle-shaped myofibroblastic cells and significant inflammatory infiltrates. This case report describes a 24-year-old male with diabetes who was admitted to the hospital for over three days of vomiting and abdominal pain and was initially diagnosed with diabetic ketoacidosis. Upon admission, an abdominal CT scan revealed a large cystic-solid mass in the abdominal cavity and multiple nodules in the mesentery, omentum, and peritoneum, suggesting a preliminary diagnosis of an intra-abdominal mesenchymal tumor with peritoneal metastasis.
View Article and Find Full Text PDFCurr Med Res Opin
January 2025
Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
The GLP-1 receptor-based agonists (GLP-1RAs) and SGLT2 inhibitors (SGLT2i) are major 21 century breakthroughs in diabetes and obesity medicine but there are important safety considerations regarding the perioperative and periprocedural management of individuals who are treated with these agents. GLP-1RAs have been linked to an increased risk of retained gastric contents and pulmonary aspiration while SGLT2i can be associated with diabetic ketoacidosis. This manuscript provides a narrative review of the available evidence for perioperative and periprocedural risks in people prescribed GLP-1RAs and SGLT2i.
View Article and Find Full Text PDFCurr Diabetes Rev
January 2025
Department of Pharmacology, Central University of Punjab, Ghudda, Bathinda, 151401, India.
The connection between COVID-19 and DM unveils a multifaceted interplay that significantly impacts disease severity and management strategies. Initial studies reveal that people with DM had higher severity rates of COVID-19 due to the infection by SARS-CoV-2. The virus solely induces hyperglycemia and, at the same time, profoundly influences the immune and inflammatory reactions, increasing the rate of severe complications and death among diabetes patients.
View Article and Find Full Text PDFJ Community Hosp Intern Med Perspect
January 2025
Department of Medicine, Division of General Internal Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
Acute pancreatitis is a frequent cause of hospital admission, managed with intravenous (IV) fluids, analgesia, and oral feeding when tolerated. In patients with hypertriglyceridemia-induced pancreatitis, insulin and other therapies may be necessary for disease resolution. We present a case of a patient with severe acute pancreatitis and euglycemic diabetic ketoacidosis (DKA) with known lipase maturation factor 1 (LMF1) gene mutations, which can impact insulin efficacy on triglyceride metabolism through altered lipoprotein lipase activity, successfully treated with intravenous insulin.
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