EASD 2019 — Sotagliflozin + insulin superior to insulin alone for glycemia in T1D


  • Brandon May
  • Conference Reports
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Takeaway

  • Sotagliflozin, a dual sodium-glucose cotransporter type-1 and -2 inhibitor, improves glycemic control and leads to weight reduction in insulin-treated patients with type 1 diabetes (T1D).

 Why this matters

  • Almost half of patients with T1D are overweight or obese, and a sizable proportion of these patients also have inadequately controlled disease.

Study design

  • Post hoc analysis that examined the use of sotagliflozin as an adjunct to insulin for glycemic control and weight reduction over a 24-week period in patients with T1D and a baseline body mass index of ≥27 kg/m2.
  • Patients were randomly assigned to 3 groups:
    • Sotagliflozin 200 mg (n=305);
    • Sotagliflozin 400 mg (n=313);
    • Insulin alone (n=298).
  • Safety endpoints were examined at 52 weeks.
  • Funding: Lexicon Pharmaceuticals Inc. and Sanofi.

Key results

  • Greater reductions in HbA1c with sotagliflozin 200 mg (least mean squares difference [LMSD], −0.39; P<.001 and mg p vs insulin alone.>
  • Compared with insulin alone, sotagliflozin was associated with greater reductions in body weight with the 200 mg dose (LMSD, −2.27; P<.001 and the mg dose p>
  • Fewer severe hypoglycemia events were observed in the sotagliflozin group. 
  • Sotagliflozin was associated with a higher diabetic ketoacidosis incidence.

Limitations

  • Relatively short follow-up period and lack of an active comparator drug.