Sglt2-inhibitors In Type 1 Diabetes: Dka Risk Can Be Different Between Agents
SGLT2-inhibitors in type 1 diabetes: DKA risk can be different between agents Current therapeutic options for treating type 1 diabetes (T1DM) remain very limited, with insulin being the mainstay of therapy. However, the data presented at the European Association for the Study of Diabetes (EASD) 2017 Annual Meeting have revealed that selective sodium-glucose co-transporter 2 (SGLT2) inhibitors in addition to daily insulin may bring additional glycemic control and weight loss, albeit with a varying risk of diabetic ketoacidosis (DKA).1,2 One of the promising approaches being investigated to treat T1DM is to add an adjunct agent on top of insulin therapy, to further control the blood glucose without increasing the risk of hypoglycemia, weight gain, and DKA (which is more common in T1DM).3 Owing to the insulin-independent mechanism of action of SGLT2-inhibitors, several clinical trials have been conducted to examine their adjunct use in treating T1DM patients, two of which (DEPICT-1 and InTandem3) showed that SGLT2-inhibitors are an effective adjunct for inadequately controlled T1DM.4,5 DEPICT-1: Promising outcomes with dapagliflozin in T1DM patients DEPICT-1 was a phase 3, double-blind, randomized, parallel-controlled, multicenter study that investigated the safety and efficacy of dapagliflozin (5mg or 10mg) plus daily insulin in 833 patients (aged 18-75 years old) with inadequately controlled T1DM (HbA1c between 7.7% and 11.0%). Patients were randomized at approximately 1:1:1 to three study arms (dapagliflozin 5mg + insulin; dapagliflozin 10mg + insulin; placebo + insulin), with the primary efficacy outcome being the change from baseline in HbA1c at week 24. The results of this unprecedented study were presented by Dr. Paresh Dandona at the EASD 2017 Annual Meeting, and Continue reading >>
Are Sglt2 Inhibitors A Good Complement To Insulin Therapy In Type 1 Diabetes?
This study examined whether SGLT-2 inhibitors were effective as a complement to insulin therapy in type 1 diabetes.The authors concluded that SGLT-2 Inhibitors had the potential to be a complementary treatment option. Patients with type 1 diabetes (T1D) do not produce enough insulin (a hormone) to control their blood sugar levels. They thus need to be treated with additional insulin in order to manage their blood sugar.Insulin therapy can sometimes, hower, cause weight gain and / or hypoglycemia (dangerously low blood sugar). In recent years, new complementary treatments (which aim to reduce side effects) have become available.Sodium glucose co-transporter 2 (SGLT-2) inhibitors are a possible complementary treatment option. They have been effective in treating patients with type 2 diabetes.It is unclear, however, how SGLT-2 Inhibitors affect patients with T1D. This study investigated whether SGLT-2 inhibitors were a safe and effective add-on treatment for T1D. It summarized the results of seven clinical trials, including 581 patients. Compared with those not treated with SGLT-2 inhibitors, those treated with SGLT-2 inhibitors (in addition to insulin) reduced their fasting blood sugar by 0.69 mmol/L (blood glucose after a period without food or drink).Those on SGLT-2 inhibitors also reduced their HbA1C (average blood glucose over 3 months) by 0.37%, their bodyweight by 2.54kg and their total daily insulin dose by 6.22IU. There were no differences in events of hypoglycemia seen in each group. However,16 patients treated with SGLT-2 inhibitors expierenced diabetic ketoacidosis(a potentially dangerous condition resulting in extremely high blood sugar). This study concluded that SGLT-2 Inhibitors may be a useful "add-on" treatment option for patients with T1D. Larger and lo Continue reading >>
Sglt2 Inhibitors And Dka In People With Type 1 Diabetes
SGLT2 Inhibitors and DKA in People With Type 1 Diabetes Treating type 1 diabetes with insulin alone can be a challenge. One fairly new class of drugs, SGLT2 inhibitors, appears to be an effective add-on treatment. It reduces blood glucose levels, body weight, and the amount of insulin patients need. Also, it does not increase the frequency ofhypoglycemia(low blood glucose levels) in people with either type 1 or type 2 diabetes. However, the drug may increase the risk of diabetic ketoacidosis (DKA), a dangerous form of extremehyperglycemia(high blood glucose levels) that can lead tocomaor even death. How real is that risk? A total 351 people with poorly controlled type 1 diabetes signed up for the study. All either took multiple daily injections of insulin or used an insulin pump, which continuously delivers insulin under the skin. The participants were randomly assigned to one of two groups for the 18-week study. One group took the study drug canagliflozin, an SGLT2 inhibitor, at 100 or 300 mg once a day. The other group was given a placebo, which resembled the treatment pill but had no active ingredients. The goal: to determine which group had a higher number of participants who experienced DKA. Canagliflozin, an SGLT2 inhibitor, appears to boost the risk of serious DKA, at least when taken at the higher dose. However, the patients monitored themselves for ketones throughout the study. That means it is possible that some of them made mistakes, which could have affected the results of the study. If you take canagliflozin, be aware of the potential risks and know how to monitor yourself for any changes in your ketone levels. Talk to your doctor about these concerns and be aware of the symptoms of DKA and the circumstances in which it is most likely to occur. Diabetic Ke Continue reading >>
Effects Of Sotagliflozin Added To Insulin In Patients With Type 1 Diabetes
In most patients with type 1 diabetes, adequate glycemic control is not achieved with insulin therapy alone. We evaluated the safety and efficacy of sotagliflozin, an oral inhibitor of sodium–glucose cotransporters 1 and 2, in combination with insulin treatment in patients with type 1 diabetes. In this phase 3, double-blind trial, which was conducted at 133 centers worldwide, we randomly assigned 1402 patients with type 1 diabetes who were receiving treatment with any insulin therapy (pump or injections) to receive sotagliflozin (400 mg per day) or placebo for 24 weeks. The primary end point was a glycated hemoglobin level lower than 7.0% at week 24, with no episodes of severe hypoglycemia or diabetic ketoacidosis after randomization. Secondary end points included the change from baseline in glycated hemoglobin level, weight, systolic blood pressure, and mean daily bolus dose of insulin. A significantly larger proportion of patients in the sotagliflozin group than in the placebo group achieved the primary end point (200 of 699 patients [28.6%] vs. 107 of 703 [15.2%], P<0.001). The least-squares mean change from baseline was significantly greater in the sotagliflozin group than in the placebo group for glycated hemoglobin (difference, −0.46 percentage points), weight (−2.98 kg), systolic blood pressure (−3.5 mm Hg), and mean daily bolus dose of insulin (−2.8 units per day) (P≤0.002 for all comparisons). The rate of severe hypoglycemia was similar in the sotagliflozin group and the placebo group (3.0% [21 patients] and 2.4% , respectively). The rate of documented hypoglycemia with a blood glucose level of 55 mg per deciliter (3.1 mmol per liter) or below was significantly lower in the sotagliflozin group than in the placebo group. The rate of diabetic keto Continue reading >>
Sglt2 Inhibitors In Treatment Of Type 1
Meta-analysis explores safety and efficacy of sodium-glucose co-transporter 2 inhibitors in patients with type 1 diabetes. Individuals living with type 1 diabetes most of their lives are exposed to numerous comorbidities that ultimately lead to a significant decrease in estimated life expectancy by approximately 12 years, as we have seen with former studies conducted on the subject. Moreover, considering that patients with type 1 are treated with insulin as their main option for managing blood sugar levels, these individuals have augmented peril to experience serious dose-dependent side-effects such as hypoglycemia or weight gain. Use of oral medications for management of T1D has been investigated before without much success, save for oral pramlintide. When used in combination with insulin for type 2, the new kids in town, SGLT2 inhibitors, have shown to decrease the insulin need, weight gain, and hypoglycemia. But, would the similar effects be produced in patients with type 1 following the combination therapy? To establish a place for SGLT2s in type 1 diabetes, researchers conducted a systematic review and meta-analysis of randomized controlled trials. Their findings were recently published in Diabetes Research and Clinical Practice. El Masri and colleagues conducted a literature review of PubMed, Embase, Scopus, Web of Science and Cochrane library to screen for potential RCTs concerning the use of SGLT2-i in T1D to be included into the meta analysis. Studies that included patients with type 2, or those studies that did not include original data were excluded from the systematic review. Four randomized controlled trials were included with the primary outcome of the analysis being to establish the extent SGLT2-i lead to changes in body weight, insulin need, and HbA1c l Continue reading >>
Efficacy And Safety Of Sglt2 Inhibitors In Patients With Type 1 Diabetes: A Meta-analysis Of Randomized Controlled Trials.
Efficacy and Safety of SGLT2 Inhibitors in Patients with Type 1 Diabetes: A Meta-analysis of Randomized Controlled Trials. Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Medical College Hospital, Chinese Academy of Medical Sciences & Peking Medical College, Beijing 100730, China. Health Science Popularization Research Center, Chinese Academy of Medical Sciences & Peking Medical College, Beijing 100730, China. Objective To assess the efficiency and safety of a novel sodium-glucose co-transporter 2 (SGLT2) inhibitor-SGLT2 inhibitors, in combination with insulin for type 1 diabetes mellitus (T1DM). Methods We searched Medline, Embase, and the Cochrane Collaboration Library to identify the eligible studies published between January 2010 and July 2016 without restriction of language. The Food and Drug Administration (FDA) data and ClinicalTrials (were also searched. The included studies met the following criteria: randomized controlled trials; T1DM patients aged between 18 and 65 years old; patients were treated with insulin plus SGLT2 inhibitors for more than 2 weeks; patients' glycosylated hemoglobin (HbA1c) levels were between 7% and 12%. The SGLT2 inhibitors group was treated with SGLT2 inhibitors plus insulin, and the placebo group received placebo plus insulin treatment. The outcomes should include one of the following items: fasting blood glucose, HbA1c, glycosuria, or adverse effects. Data were analyzed by two physicians independently. The risk of bias was evaluated by using the Cochrane Collaboration's Risk of Bias tool and heterogeneity among studies was assessed using Chi-square test. Random effect model was used to analyze the treatment effects with Revman 5.3.Results Three trials including 178 patients were enrolled. Continue reading >>
Efficacy And Safety Of Sglt2 Inhibitors In Patients With Type 1 Diabetes: A Meta-analysis Of Randomized Controlled Trials - Sciencedirect
Volume 32, Issue 1 , March 2017, Pages 22-27 Efficacy and Safety of SGLT2 Inhibitors in Patients with Type 1 Diabetes: A Meta-analysis of Randomized Controlled Trials Author links open overlay panel YingyingYanga HuiPana Get rights and content To assess the efficiency and safety of a novel sodium-glucose co-transporter 2 (SGLT2) inhibitorSGLT2 inhibitors, in combination with insulin for type 1 diabetes mellitus (T1DM). We searched Medline, Embase, and the Cochrane Collaboration Library to identify the eligible studies published between January 2010 and July 2016 without restriction of language. The Food and Drug Administration (FDA) data and ClinicalTrials ( ) were also searched. The included studies met the following criteria: randomized controlled trials; T1DM patients aged between 18 and 65 years old; patients were treated with insulin plus SGLT2 inhibitors for more than 2 weeks; patients' glycosylated hemoglobin (HbA1c) levels were between 7% and 12%. The SGLT2 inhibitors group was treated with SGLT2 inhibitors plus insulin, and the placebo group received placebo plus insulin treatment. The outcomes should include one of the following items: fasting blood glucose, HbA1c, glycosuria, or adverse effects. Data were analyzed by two physicians independently. The risk of bias was evaluated by using the Cochrane Collaboration's Risk of Bias tool and heterogeneity among studies was assessed using Chi-square test. Random effect model was used to analyze the treatment effects with Revman 5.3. Three trials including 178 patients were enrolled. As compared to the placebo group, SGLT2 inhibitor absolutely decreased fasting blood glucose [mean differences (MD) 2.47 mmol/L, 95% confidence interval (CI) 3.65 to 1.28, P<0.001] and insulin dosage (standardized MD 0.75 U, 95%CI 1.17 Continue reading >>
Sglt2 Inhibitor Has Some Utility In Type 1 Diabetes
SGLT2 Inhibitor Has Some Utility in Type 1 Diabetes But canagliflozin use increases risk for ketoacidosis by Parker Brown Parker Brown, Staff Writer, MedPage Today Note that this randomized trial of canagliflozin found an elevated risk of DKA in treatment arms at various doses, but no DKA events in those receiving placebo. Note that the SGLT-2 inhibitor class has been associated with DKA in other studies as well. Canagliflozin (Ivokana), an SGLT-2 inhibitor for patients with type 2 diabetes, increased risk of ketoacidosis when used in patients with type 1 diabetes. The drug was associated with a serious case of diabetic ketoacidosis (DKA) in five of 117 patients on 100 mg/day of the drug and in seven of 117 on 300 mg/day in an 18-week trial funded by Janssen, which markets the drug. None of the 117 patients in the placebo group had DKA, reported Anne Peters, MD , at the University of Southern California, and colleagues in Diabetes Care . After 18 weeks, the incidence of any ketone-related adverse event was 5.1% (n=6) in the 100-mg group and 9.4% (n=11) in the 300-mg group. "Because of the potentially life-threatening nature of DKA in patients with type 1 diabetes, further development of SGLT2 inhibitor therapy as a treatment for type 1 diabetes should proceed with caution," concluded the authors. Among those who had serious adverse events, blood glucose levels varied from 9.4 to more than 44.4 mmol/L (170 to >800 mg/dL). There were no significant differences at baseline between the treatment and control groups that predicted a ketone related adverse event. The FDA issued a warning last May that canagliflozin and other drugs in the class -- dapagliflozin (Farxiga) and empagliflozin (Jardiance) -- were associated with ketoacidosis. Efficacy results from the trial were re Continue reading >>
The Efficacy And Safety Of Sglt2 Inhibitors For Adjunctive Treatment Of Type 1 Diabetes: A Systematic Review And Meta-analysis.
Generate a file for use with external citation management software. Sci Rep. 2017 Mar 9;7:44128. doi: 10.1038/srep44128. The efficacy and safety of SGLT2 inhibitors for adjunctive treatment of type 1 diabetes: a systematic review and meta-analysis. Department of Endocrinology, Affiliated Hospital of Southwest Medical College, Luzhou, Sichuan 646000, China. Beth Israel Deaconess Medical Center, Boston, MA, Boston, MA, USA. To assess the efficacy and safety of the SGLT-2 inhibitors as adjunct therapy to insulin in T1DM, clinical trials indexed in PubMed, Cochrane Library, EMbase from inception through April 5, 2016. A meta-analysis was conducted on trials of SGLT-2 inhibitors in patients with T1DM on insulin therapy using RevMan 5.3 software. Of the 371 articles identified, ten met eligibility criteria. Seven clinical trials including four randomized controlled trials and 581 patients were included. Compared with the control group, SGLT-2 inhibitors group had significantly reduced fasting plasma glucose by 0.69 mmol/L [1.32; 0.07], glycosylated hemoglobin A1C by 0.37% [0.54; 0.20], body weight by 2.54 kg [3.48; 1.60] and total daily insulin dose by 6.22 IU [8.04; 4.40]. The total incidence of adverse events (AEs), hypoglycemia, and genital and urinary infections were also similar to placebo, while an increased incidence of diabetic ketoacidosis (DKA) (n = 16) was seen in SGLT-2 inhibitors group. The present study demonstrates that SGLT-2 inhibitors are effective as adjunct therapy to insulin in T1DM, heralding improved glycemic control, reduced body weight and total daily insulin dose without an increase in total AEs, hypoglycemia, or genital and urinary infections. However, the risk of DKA should be carefully monitored in future clinical trials. Continue reading >>
Sglt2 Inhibitor Tested In Type 1 Diabetes
SGLT2 Inhibitor Tested in Type 1 Diabetes The oral sodium-glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin had acceptable short-term tolerability when given as an adjunct to insulin in patients with type 1 diabetes, with expected increases in urinary glucose excretion seen with this class of drugs. Although hypoglycemia was common, patients assigned to the study drug had reductions in 24-hour daily average blood glucose levels, glycemic variability, and mean percent change in total daily insulin dose, according to study results published in Diabetes Care.. Dapagliflozin, which is currently approved as an adjunct to diet and exercise in adults with type 2 diabetes, reduces glycemic levels by inhibiting the reabsorption of renal glucose independently of insulin. The efficacy of dapagliflozin and other SGLT2 inhibitors in patients with type 2 diabetes suggests that this oral therapeutic may provide a new option for patients with type 1 diabetes as well, according to researchers led by Robert R. Henry, MD, of San Diego Healthcare System. The researchers designed this pilot study as a proof-of-concept study to test the safety and tolerability of dapagliflozin in this patient population. The study included 62 adults with type 1 diabetes who had an HbA1c of 7% to 10%. Patients were randomly assigned to one of four dapagliflozin doses or placebo for 2 weeks. All patients were also receiving stable doses of insulin. At least 60% of patients in all the treatment groups reported at least one hypoglycemic event during the study period; however, only one of these events was considered a major event. The researchers observed no relationship between the assigned dose of the study drug and the rates of hypoglycemia. No difference in the 7-point glucose monitoring levels was fou Continue reading >>
Sglt2 Inhibitors | The Johns Hopkins Patient Guide To Diabetes
These medications typically lower HbA1c levels by 0.5 1% after about 6 months of therapy. Some patients report mild weight loss after taking SGLT2 inhibitors. SGLT2 inhibitors may increase urination and raise the risk of female yeast infections and urinary tract infections. These drugs can also lead to low blood pressure . Kidney function needs to be tested before and during treatment with SGLT2 inhibitors Persons with severe kidney disease or on dialysis are not recommended to be on this medicine New evidence suggests that SGLT2 inhibitors might be related to the development of diabetic ketoacidosis in some patients Though use of SGLT2 inhibitors in type 1 diabetes has been described, the safety of these drugs has not been studied and are not currently FDA recommended for the management of type 1 diabetes WARNING!Women who are pregnant or who are breastfeeding should not take these medications. SGLT2 inhibitors are classified by the FDA as Category C drugs, which means that they are not considered safe during pregnancy. Continue reading >>
Sodium-glucose Co-transporter-2 Inhibitors In Type 1 Diabetes—a Dangerous Ally
Abstract: There is an unmet need for adjunctive non-insulin-based therapies in type 1 diabetes (T1D). Weight gain, recurrent hypoglycemia and suboptimal glycemic control remain significant challenges. Sodium-glucose co-transporter-2 (SGLT2) inhibitors and dual inhibitors of sodium-glucose co-transporter-1 (SGLT1) and SGLT2 may have a potential role as an add-on therapy to insulin. The benefits include improved glycemic control, weight reduction, and reduced insulin dose requirement. However, the risk of diabetic ketoacidosis with SGLT2 inhibitors is significant and the diagnosis may be delayed due to absence of significant hyperglycemia. At present, SGLT2 inhibitors are not approved for use in T1D, and the risks should be discussed at length with the patient. We propose strategies to minimize the risk of diabetic ketoacidosis associated with off-label use of SGLT2 inhibitors in T1D. Keywords: Type 1 diabetes, diabetic ketoacidosis, euglycemic diabetic ketoacidosis, sodium-glucose co-transporter-2 (SGLT2) inhibitors Disclosure: Gagan Priya, Sanjay Kalra, and Vishal Bhambri have nothing to declare in relation to this article. No funding was received in the publication of this article. Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, adaptation, and reproduction provided the original author(s) and source are given appropriate credit. There is a rising trend of overweight and obesity in individuals with type 1 diabetes (T1D). The prevalence of overweight and obesity among newly diagnosed T1D subjects was 21–22% in the 2–19 year age group in the Pediatric Diabetes Consortium and the SEARCH for Diabetes in Youth study.1,2 This has been attributed to a general worldwide i Continue reading >>
Could Sglt2 Inhibitors Eventually Be Approved As A Type 1 Diabetes Treatment?
Could SGLT2 inhibitors eventually be approved as a type 1 diabetes treatment? Could SGLT2 inhibitors eventually be approved as a type 1 diabetes treatment? Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a relatively new drug class for treating type 2 diabetes, and while they have significant benefits, they also carry significant risks and side effects. It is therefore intriguing that SGLT2s are being investigated as a type 1 diabetes treatment, but will the side effects of the drugs outweigh any benefits that could be attained? SGLT2 inhibitors were approved for treating type 2 diabetes in 2013 specifically, in patients with high blood glucose levels who cannot tolerate metformin and a sulfonylurea or pioglitazone is not appropriate.  The drugs can lower blood glucose levels and have benefits for weight loss, making them a valuable treatment for type 2 diabetes. One SGLT2 drug, Jardiance (empagliflozin), has also showed promise for cardiovascular health: in 2015 it reduced the risk of risk of cardiovascular death by 38 per cent in people with type 2 diabetes, compared to placebo. It is not surprising, consequently, that SGLT2s are being investigated in type 1 diabetes research. Despite the benefits, SGLT2s have their problems. They have been associated with increased incidences of diabetic ketoacidosis (DKA) , a dangerous short-term complication, to risks of acute kidney failure. Furthermore, long-term side effects of the drugs remain unclear. Considering SGLT2 inhibitors have been the subject of numerous health warnings in recent years, youd forgive people with type 1 diabetes for possibly grimacing in fear when talk of SGLT2 research occurs. But a number of studies have shown that SGLT2 drugs such as Forxiga (dapagliflozin) and Invokana (canagliflozin) cou Continue reading >>
Sglt2 Inhibitors In Type 1 Diabetes
Alyson P. Lozicki, PharmD; Nicholas D. Franz, PharmD Candidate Are SGLT2 inhibitors safe and effective in patients with type 1 diabetes? Drug Information Research Fellow, Creighton University, Omaha, Nebraska Creighton University School of Pharmacy and Health Professions, Omaha, Nebraska Type 1 diabetes (T1D) is caused by the autoimmune destruction of insulin-producing islet cells in the pancreas, resulting in an absolute deficiency of insulin. Treatment requires the exogenous replacement of insulin. This etiology differs from type 2 diabetes (T2D), which is primarily characterized by insulin resistance, and treatment focuses on enhancing insulin sensitivity and lowering blood glucose.[ 1 ] Current guidelines from the American Diabetes Association (ADA) support an intensive insulin regimen for T1D, citing the Diabetes Control and Complications Trial, which demonstrated improvements in vascular and all-cause mortality outcomes with such a regimen. The benefits are clear; however, the multiple injections and adverse effects of insulin compound the burden of disease. Weight gain and the risk for hypoglycemia are most concerning and can cause increased comorbidities and poor compliance.[ 2 ] Oral antidiabetic agents approved for T2D are presently being investigated as adjuncts to insulin to address these concerns.[ 1 ] Among these are sodium-glucose cotransporter 2 (SGLT2) inhibitors, which are potentially effective due to their mechanism independent of insulin and associated weight loss.[ 3 ] SGLT2 inhibitors reduce the reabsorption of glucose from the proximal renal tubules and lower the renal threshold for glucose, thus increasing urinary glucose excretion and decreasing blood glucose concentrations.[ 4 ] Studies have demonstrated the effectiveness of SGLT2 inhibitors a Continue reading >>
Researchers Testing Sglt2 Drugs For Type 1 Use
Researchers Testing SGLT2 Drugs for Type 1 Use The popular Type 2 medication is already being used off-label as an add-on to insulin therapy. Pharma companies are testing whether drugs designed for combatting Type 2 diabetes can be used to also treat Type 1 diabetes. The latest attempt involves a class of of oral antidiabetics called SGLT2 inhibitors, first cleared by the Food and Drug Administration on March 29, 2013. There have been roughly 100 clinical trials involving SGLT2 drugs logged at the National Institutes of Health since researchers first began evaluating canagliflozin. All but two have involved individuals with Type 2 diabetes or those who dont have diabetes. Recently, there have been studies undertaken to evaluate SGLT2 drugs as an add-on to insulin therapy; the following trials involve people with Type 1 diabetes: The drug company Janssen initiated an SGLT2 trial in May 2014 in the U.S. and Canada. 232 participants were enrolled to investigate whether 100 mg and 300 mg canagliflozin doses with insulin would help better control blood sugar levels than insulin alone. Phase II of this trial was completed in June 2015, and the study process came under some criticism, but full results have not been posted. In February 2016, Yale Medical School and the National Institutes of Diabetes and Digestive and Kidney Disease (NIDDK) filed for a 20-patient study to administer canagliflozin during interruptions in insulin therapy. Researchers have begun recruiting at the Yale New Haven Hospital Research Unit. In December 2015, diaTribe reported the launch of two one-year studies to test the administration of the SGLT2 drug empagliflozin in three different doses. The trial, which is recruiting participants in the U.S., Canada, and the EU, is expected to complete its third Continue reading >>