INS and Hyperglycemia: In Japan, postmarketing surveillance identified DKA–related deaths, prompting the Japan Diabetes Society to issue a safety alert in April 2025 regarding the risk of hyperglycemia and DKA associated with capivasertib.2) We present a case of grade 4 hyperglycemia in a patient without diabetes who was receiving capivasertib, successfully managed with early insulin intervention before the onset of DKA.