Mutations in PIK3CA, the gene encoding the p110a catalytic subunit of PI3K, are among the most common mutations found in human cancer and have also recently been implicated in a range of overgrowth syndromes in humans. We have used a novel inducible "exonswitch" approach to knock in the constitutively active Pik3ca H1047R mutation into the endogenous Pik3ca gene of the mouse. Ubiquitous expression of the Pik3ca H1047R mutation throughout the body resulted in a dramatic increase in body weight within 3 weeks of induction (mutant 150 6 5%; wild-type 117 6 3%, mean 6 SEM), which was associated with increased organ size rather than adiposity. Severe metabolic effects, including a reduction in blood glucose levels to 59 6 4% of baseline (11 days postinduction) and undetectable insulin levels, were also observed. Pik3ca H1047R mutant mice died earlier (median survival 46.5 d post-mutation induction) than wild-type control mice (100% survival > 250 days). Although deletion of Akt2 increased median survival by 44%, neither organ overgrowth, nor hypoglycemia were rescued, indicating that both the growth and metabolic functions of constitutive PI3K activity can be Akt2 independent. This mouse model demonstrates the critical role of PI3K in the regulation of both organ size and glucose metabolism at the whole animal level.-Kinross, K. M., Montgomery, K. G., Mangiafico, S. P., Hare, L. M., Kleinschmidt, M., Bywater, M. J., Poulton, I. J., Vrahnas, C., Henneicke, H., Malaterre, J., Waring, P. M., Cullinane, C., Sims, N. A., McArthur, G. A., Andrikopoulos, S., Phillips, W. A. Ubiquitous expression of the Pik3ca H1047R mutation promotes hypoglycemia, hypoinsulinemia, and organomegaly. FASEB J. 29, 1426-1434 (2015). www.fasebj.org Key Words: PI3K • p110a • mouse model • overgrowth syndrome • glucose metabolism CLASS I PI3KS ARE A UBIQUITOUS family of lipid kinases that play a key role in regulating a wide range of important cellular processes including proliferation, growth, survival, angiogenesis, metabolism, and migration (1). PI3Ks are comprised of a unique catalytic subunit (p110a, b, or d) along with one of a number of shared regulatory subunits (p85a, p85b, and p55g). PI3Ks are activated by growth factor stimulation of receptor tyrosine kinases, and catalyze the phosphorylation of phosphatidylinositol-4,5-bisphosphate (PI(4,5)P 2 ) to form PI(3,4,5)P 3 . The second messenger PI(3,4,5)P 3 then activates a series of downstream signaling pathways, including the AKT/mammalian target of rapamycin pathway. The activity of PI3K can be opposed by the phosphatase PTEN (phosphatase and tensin homolog), which dephosphorylates PI(3,4,5)P 3 returning it back to PI(4,5)P 2 (1, 2).