Can sotagliflozin improve kidney function in patients with Type 1 diabetes?

This study examined whether sotagliflozin (Zynquista) helped improve kidney function in patients with Type 1 diabetes (T1D). The authors concluded that sotagliflozin improved several factors of kidney function.

The goal of treatment for patients with T1D is to lower blood glucose levels. However, many patients develop additional health complications because of T1D. One of these complications is kidney disease, which affects about 20 – 40% of patients with T1D. This condition affects normal kidney function and can lead to kidney failure.

Sotagliflozin is a sodium-glucose co-transporter (SGLT) inhibitor. SGLT inhibitors help the kidneys remove glucose from the body through the urine. Previous studies have shown that sotagliflozin helps improve blood sugar control and body weight in patients with Type 2 diabetes. The effects of sotagliflozin in patients with T1D remain under investigation.

This study examined 1575 patients with T1D. Patients were divided into three groups. The first two groups received sotagliflozin at either 200 mg (524 patients) or 400 mg (525 patients). The third group received a placebo (a substance with no active effect; 526 patients). Patients were followed-up for 1 year.

Kidney blood filtration is a measurement of kidney function and is increased in kidney disease.  Compared to the placebo group, kidney blood filtration decreased by 2.0 mL/min/1.73 m² in the 200 mg group and by 0.5 mL/min/1.73 m² in the 400 mg group.

Blood pressure is measured by systolic blood pressure (SBP; blood pressure when the heart beats) and diastolic blood pressure (DBP; blood pressure when the heart rests between beats). At follow-up, patients in the 400 mg group had a significant drop in SBP compared to the 200 mg group (3.6 mmHg vs. 2.9 mmHg). DBP decreased by a similar amount in both groups (1.6 mmHg vs. 1.4 mmHg).

Albumin and creatinine (A/C) are two proteins found in urine.  A high ratio of albumin to creatinine (A/C) can indicate kidney disease. Patients in the 400 mg group had a larger decrease in the A/C ratio compared to the 200 mg group (23.7% vs. 18.3%).

Patients in the 400 mg group also had significantly more weight loss compared to patients in the 200 mg group (3.6 kg lost vs. 2.7 kg lost).

This study concluded that sotagliflozin improved several factors of kidney function in patients with T1D, including blood filtration, blood pressure, and A/C ratio. The authors suggest that improved kidney function may be an additional benefit of sotagliflozin treatment beyond lowering blood sugar levels for these patients.

This study was funded by the manufacturers of sotagliflozin, Lexicon and Sanofi. This study did not include patients who specifically had kidney disease. Also, this study looked back in time to analyze data and had a short follow-up time. More studies are needed to confirm these results.

Talk to your doctor about your treatment options to prevent or reduce signs of kidney disease.