Sotagliflozin (Zynquista™) is the first dual inhibitor of sodium-glucose 
co-transporter-1 and -2 (SGLT1 and 2). In the phase 3, inTANDEM 1-3 trials, 
adjunctive use of oral sotagliflozin (200 mg or 400 mg once daily) improved 
glycaemic control and reduced bodyweight and insulin requirements relative to 
placebo over 24 weeks of treatment in adults whose type 1 diabetes (T1D) was 
inadequately controlled by insulin therapy. Similar benefits were seen with the 
drug in patients who were overweight/obese [i.e. body mass index (BMI) 
≥ 27 kg/m2] in inTANDEM 1 and 2 (pooled). The benefits of sotagliflozin were 
largely maintained over 52 weeks of treatment. Overall, use of sotagliflozin in 
this setting is generally well tolerated and reduces, or at least does not 
increase, the likelihood of hypoglycaemia; however, as with other SGLT 
inhibitors, sotagliflozin carries a risk of diabetic ketoacidosis (DKA). On the 
basis of its risk/benefit profile, sotagliflozin is indicated in the EU as an 
adjunct to insulin in adults with T1D with a BMI ≥ 27 kg/m2 who have failed to 
achieve adequate glycaemic control despite optimal insulin therapy, thus 
expanding the currently limited adjunctive oral treatment options available for 
use in this population.