How Do SGLT1 Inhibitors Work?

Sodium-glucose co-transporters or sodium glucose-linked transporters (SGLTs) are relatively a new class of drugs that work by increasing urinary glucose excretion. SGLT1 and SGLT2 are a family of glucose transporter found in the intestinal mucosa (enterocytes) of the small intestine and the proximal tubule of the nephron (functional unit of the kidney). SGLT1 inhibitor is currently being studied and pending Food and Drug Administration (FDA) approval for adults with type 1 diabetes mellitus (T1DM) in combination with insulin therapy. T1DM is a condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood.

The kidney filters and reabsorbs glucose which is assisted by active SGLTs and passive glucose transporters. It releases glucose into the circulation by two processes:

• Glycogenolysis: breakdown of glycogen to generate glucose
• Gluconeogenesis: synthesis of free glucose from lactate, pyruvate, and amino acids

"Sotagliflozin" is the first oral SGLT1 inhibitor developed to treat adult patients with T1DM in combination with insulin, which is to be reviewed by the FDA. Studies have shown that people with T1DM who take sotagliflozin in addition to optimized insulin therapy have lower hemoglobin A1c levels and weight and a low incidence of severe hypoglycemia (low blood sugar level) after a year of treatment.

SGLT1 inhibitor works in the following ways:

• SGLT1 inhibitor plays a crucial role in the intestinal absorption of glucose and the renal reabsorption of glucose, particularly in patients with uncontrolled diabetes and those receiving SGLT2 inhibitors.
• The inhibition of SGLT1 lowers serum glucose levels through the inhibition of intestinal absorption and renal reabsorption of glucose, thus improving post-meal glycemic control.

SGLT1 inhibitor is pending FDA approval for adults with T1DM in combination with insulin therapy.

As SGLT1 inhibitor is still in clinical trials, no adverse effects have been reported.

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of SGLT1 inhibitors include:

• Sotagliflozin (pending FDA approval)
• Zynquista (pending FDA approval)