Can An Add-on Pill for Type 1 Diabetes Improve A1c and Weight Loss?
Trial results testing sotagliflozin and Farxiga in type 1 diabetes show greater A1c lowering and weight loss, plus continued conversation about small risk of DKA
Potential “add-on” (adjunctive) treatments for type 1 diabetes played a starring role at the 2017 EASD conference. Key trial results were announced for two non-insulin drugs that come in pill form, offering people with type 1 diabetes an exciting new option to manage blood sugars.
The DEPICT 1 examined the use of Farxiga, a once-daily pill (an SGLT-2 inhibitor) currently approved for treating type 2 diabetes but not type 1, while the inTandem3 study tested an SGLT-1/2 dual inhibitor, sotagliflozin, also a once-daily pill that has not yet been approved. While these studies are not meant to be compared to each other given the general lack of standardization in the world of trial design, they both add to the excitement about the possibility of adjunct therapies for people with type 1. Both studies reported A1c reductions and weight loss – great for the push to approve add-on therapies for type 1 – along with continued discussion about diabetic ketoacidosis (DKA). With these phase 3 trial results, the companies may now choose to submit the drugs to the FDA and pursue an “indication” for use in type 1 diabetes.
The pills are taken once daily and work independent of insulin, meaning they won’t require complicated dosing. Glucose is only excreted through the urine when blood sugars are high, and then the drugs stop working when glucose levels come down.
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