An up-to-date evaluation of sotagliflozin for the treatment of type 1 diabetes

ABSTRACT

Introduction

The majority of patients with type 1 diabetes mellitus (T1DM) do not achieve glycemic targets. In addition, treatment with insulin is associated with increased risk for hypoglycemia and weight gain. Accordingly, there is an unmet need for new safe and effective glucose-lowering agents in this population. Sotagliflozin, a dual inhibitor of sodium-glucose co-transporters 1 and 2, has been recently approved for use in patients with T1DM.

Areas covered

The authors review the major trials that have evaluated the safety and efficacy of sotagliflozin and provide their expert opinion.

Expert opinion

Even though sotagliflozin reduces HbA_1 c levels and does not appear to increase the risk for hypoglycemia in most patients, the substantially increased risk for diabetic ketoacidosis limits the use of this agent to a carefully selected subgroup of patients with T1DM. Based on the existing evidence, sotagliflozin should be considered only in patients who have failed to achieve adequate glycemic control despite optimal insulin therapy, are at low risk for diabetic ketoacidosis, have been adequately trained to recognize this complication and are able to be in close contact with their physician.

KEYWORDS:

• Diabetic ketoacidosis
• hypoglycemia
• sodium-glucose co-transporter
• sotagliflozin
• type 1 diabetes

Article highlights

• Sotagliflozin reduces HbA1c levelsand does not appear to increase the risk for hypoglycemia in most patients

• Sotagliflozin is associated with substantially increased risk for ketoacidosis

• Sotagliflozin should be considered only in patients who have failed to achieve adequate glycemic control despite optimal insulin therapy, are at low risk for diabetic ketoacidosis, have been adequately trained to recognize this complication and are able to be in close contact with their physician

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript has not been funded.