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Purpose: This study aims to evaluate the association between psychiatric disorders and diabetic ketoacidosis (DKA) in patients with type 1 diabetes (T1D) treated at a tertiary care hospital., Methods: A propensity score-matched case-control study was conducted, comprising a total sample of 194 participants (97 DKA cases and 97 controls without DKA). Comprehensive data were collected on clinical, anthropometric, and socioeconomic characteristics, and psychiatric disorders were classified according to international standards., Results: The mean age of the participants was 47.4 ± 17.7 years, with 55.6% being female. Psychiatric disorders were identified in 16.5% of the study population. The prevalence of psychiatric disorders was significantly higher in DKA cases compared to controls (24.7% vs. 7.2%, p < 0.001). Conditional logistic regression models revealed that the association between psychiatric disorders and DKA was not independent of HbA1c levels. Additionally, in HbA1c-stratified analyses, patients with psychiatric disorders developed DKA at lower HbA1c levels compared to controls., Conclusion: Psychiatric disorders significantly increase the risk of DKA in adults with T1D, particularly among those with less elevated HbA1c levels. These findings highlight the critical importance of addresing psychiatric comorbidities in the management of T1D, given the severe implications and significant healthcare resource utilization associated with DKA., Competing Interests: Compliance with ethical standards. Conflict of interest: The authors declare no competing interests. Consent to publish: All authors declare that this manuscript is original, has not been published before and is not currently being considered for publication elsewhere. We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us., (© 2024. The Author(s).)

Purpose: Alpelisib is a PI3K (Phosphoinositide 3-kinases) inhibitor used for breast cancer which develops hyperglycemia based on its action on glucose metabolism regulation. This study aims to identify potential risk factors predicting hyperglycemia development and the need for multiple treatments for hyperglycemia in patients receiving Alpelisib., Methods: Fourteen women diagnosed with metastatic hormone receptor-positive breast cancer carrying PI3K mutations who initiated treatment with Alpelisib were monitored through consultations in the Oncology and Endocrinology departments. Non-parametric ROC curves were generated to assess the need for three or more antidiabetic medications to achieve glycemic control., Results: The study population had a median age of 64 years (range:48-69) with a median body mass index (BMI) of 26.6 kg/m 2 (range: 22.9-29.4). Overweight was observed in 35.7% of the participants and obesity in 21.4%. Fifty percent of the participants had prediabetes, and 85.7% developed hyperglycemia requiring pharmacological treatment, although none of them needed to discontinue treatment for this reason. Baseline C-peptide levels and BMI were associated with the number of antidiabetic drugs used (Spearman's Rho 0.553, p = 0.040; Spearman's Rho 0.581, p = 0.030, respectively). ROC curve analysis showed and area under the curve (AUC) of 0.819 for the variable risk profile (defined as baseline C-peptide >10.5 ng/ml and BMI > 27 kg/m 2 ), whereas AUC values were 0.556 and 0.514 for HbA1c and baseline glucose, respectively, (p = 0.012)., Conclusion: A joint follow-up by an Oncology department and a Diabetes Unit can prevent treatment discontinuation in patients under Alpelisib therapy. Baseline BMI and plasma C-peptide levels can predict an increased need for anti-hyperglycemic treatment., (© 2024. The Author(s).)