PIK3CA and neoplasm: Nevertheless, there are examples in which this appears to be the case, such as in certain tumors encountering resistance to PI3K inhibitors, which can respond to a ketogenic diet (which lowers insulin) or a diabetes agent (i.e., SGLT inhibitor) that affects glucose reabsorption in the kidney and presumably decreases glycolytic rate in the tumor through reducing insulin sig­naling (39).