Sotagliflozin is a dual sodium-glucose co-transporter-2 and 1 (SGLT2/1) 
inhibitor for the treatment of both type 1 (T1D) and type 2 diabetes (T2D). 
Sotagliflozin inhibits renal sodium-glucose co-transporter 2 (determining 
significant excretion of glucose in the urine, in the same way as other, already 
available SGLT-2 selective inhibitors) and intestinal SGLT-1, delaying glucose 
absorption and therefore reducing post prandial glucose. Well-designed clinical 
trials, have shown that sotagliflozin (as monotherapy or add-on therapy to other 
anti-hyperglycemic agents) improves glycated hemoglobin in adults with T2D, with 
beneficial effects on bodyweight and blood pressure. Similar results have been 
obtained in adults with T1D treated with either continuous subcutaneous insulin 
infusion or multiple daily insulin injections, even after insulin optimization. 
A still ongoing phase 3 study is currently evaluating the effect of 
sotagliflozin on cardiovascular outcomes (ClinicalTrials.gov NCT03315143). In 
this review we illustrate the advantages and disadvantages of dual SGLT 2/1 
inhibition, in order to better characterize and investigate its mechanisms of 
action and potentialities.