AIMS: To evaluate the evidence for the novel dual sodium-glucose 
co-transporter-1 (SGLT1) and -2 (SGLT2) inhibitor, sotagliflozin, which may 
enhance the efficacy of SGLT2 inhibitors by additionally reducing intestinal 
glucose absorption.
METHODS: The search terms 'sotagliflozin', 'LX4211', 'SGLT' and 'diabetes' were 
entered into PubMed. Evidence for the pharmacokinetics, pharmacodynamics, safety 
and efficacy of sotagliflozin in Type 1 and 2 diabetes was extracted from the 
retrieved literature, critically evaluated, and contextualized in relation to 
data on existing SGLT2 inhibitors.
RESULTS: There is convincing evidence from a range of phase II and III clinical 
trials that sotagliflozin significantly improves glycaemic control in both Type 
1 and Type 2 diabetes. Additional benefits, such as smaller postprandial plasma 
glucose excursions, lower insulin requirements, appetite suppression and weight 
loss have been documented. While this is encouraging, several safety concerns 
remain; a dose-dependent increase in the rate of diabetic ketoacidosis, 
diarrhoea and genital mycotic infection is apparent, although statistical 
exploration of the data regarding such events is currently lacking. 
Speculatively, use of a 200-mg rather than a 400-mg dose may help to limit 
unwanted effects.
CONCLUSIONS: The current evidence for sotagliflozin in diabetes appears 
promising. Further studies sufficiently powered to assess present and emerging 
safety concerns, as well as to identify individuals for whom sotagliflozin may 
be of particular benefit/harm would now be informative for regulatory 
decision-making. Direct comparisons with existing SGLT2 inhibitors are also 
needed to determine relative safety/efficacy profiles for the different 
indications.