In spite of developments with novel insulin preparations, novel modes of insulin 
delivery with insulin infusion pumps, and the facility of continuous glucose 
monitoring, only 20% of patients with type 1 diabetes are under adequate 
control. The need for innovation is clear, and, therefore, the use of adjunct 
therapies with other pharmacological agents currently in use for type 2 
diabetes, has been tried. Currently, pramlintide is the only agent licensed for 
use in this condition in addition to insulin. Global trials have been conducted 
with liraglutide, a glucagon-like peptide 1 receptor agonist (GLP-1RA), 
dapagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, and 
sotagliflozin, an inhibitor of both SGLT1 and SGLT2 transporters. While 
dapagliflozin and sotagliflozin have now been licensed for clinical use in this 
condition in Europe and Japan, they have hitherto not been licensed in the 
United States due to a small increase in the risk of diabetic ketoacidosis. 
However, these agents reduce glycosylated hemoglobin (HbA1c) by 0.4%, reduce 
glycemic oscillations, and do not increase the risk of hypoglycemia. 
Liraglutide, on the other hand, induced a smaller reduction in HbA1c and thus 
was not considered for a license. However, further trials are currently being 
conducted with a combination of semaglutide, the most potent GLP-1RA, and 
dapagliflozin to determine whether this approach would yield better outcomes.