INTRODUCTION: SGLT1 is the primary transporter responsible for the absorption of 
glucose and galactose in the intestine, while SGLT2 and SGLT1 are both involved 
in the renal reabsorption of glucose. SGLT2 inhibitors are a new class of oral 
antidiabetic drugs, acting by increasing urinary glucose excretion (UGE). They 
offer the advantages of a reduced risk of hypoglycaemia, a decrease in body 
weight and blood pressure and an efficacy at all stages of type 2 diabetes 
(T2DM).
AREAS COVERED: Herein, the authors focus specifically on sotagliflozin (LX4211), 
the first-in-class dual SGLT1/SGLT2 inhibitor. Original publications in English 
were selected as the basis of this review. Clinical trials were identified using 
the Clinicaltrial.gov database.
EXPERT OPINION: By a potential additional mechanism of action on intestinal 
glucose absorption linked to SGLT1 inhibition, sotagliflozin differentiates from 
SGLT2 inhibitors by reducing postprandial glucose excursion and insulin 
secretion, as well as by increasing GLP-1 secretion. Despite a weaker effect on 
UGE than selective SGLT2 inhibitors, sotagliflozin is as effective as SGLT2 
inhibitors on HbA1C reduction, with a similar safety profile in short-term 
studies. While sotagliflozin was first assessed in T2DM, it is now in phase 3 
development as an adjuvant treatment in patients with T1DM after positive 
results from a pilot study.