SLC5A2 and Hyperglycemia: Discontinue alpelisib. Make dietary adjustments (low‐carbohydrate diet) and increase physical activity first. Initiate or intensify metformin treatment. Add or resume SGLT‐2 inhibitors or other anti‐hyperglycemic agents until hyperglycemia improves. Provide intravenous rehydration and consider other appropriate management (such as interventions for electrolyte imbalances, ketoacidosis, or hyperglycemic hyperosmolar state).