In the past decade we have seen amazing results in the treatment of diabetes complications with the drug class SGLT inhibitors. They have reduced progression of kidney and heart disease in people with type 2 diabetes and improve glycemic control in type 1 diabetes, but it is not clear how they work.”Professor Peter Rossing, Head of Complications Research Leader at Steno Diabetes Centre Copenhagen
13 October 2023
£1.3 million to investigate medication with potential to delay kidney complications
King’s is a co-recipient of a £1.3 million grant to investigate the potential of a drug that could delay the progression of kidney disease in people living with type 1 diabetes.
The grant will enable researchers at King’s and the Steno Diabetes Center Copenhagen to study the effects of sotagliflozin, a Sodium-Glucose Co-Transporter (SGLT) inhibitor, on people with type 1 and kidney disease through a significant clinical trial. There are currently no approved medications to treat kidney disease in people with type 1 diabetes.
Over the past decade, SGLT inhibitors have proven to be effective for people with type 2 diabetes and people without diabetes, reducing the progression of kidney disease and heart disease.
However, there has been a lack of research exploring SGLT inhibitors as a treatment for people with kidney disease and type 1 diabetes. This award from Juvenile Diabetes Research Foundation (JDRF) means that this can be explored for the first time.
The trial will take place at the Steno Diabetes Center Copenhagen and at King's, where clinicians will recruit participants from across southeast London. Researchers will investigate how the drug, sotagliflozin, works on the kidneys using magnetic resonance imaging (MRI), which can provide a measure of kidney function and oxygen content, as well as measure a potential benefit on the heart.
“Understanding how SGLT inhibitors work is important for the optimal use, and as there is no current approved medication for treatment of kidney disease in people with type 1 diabetes, our study could help pave the way if a benefit is demonstrated,” Professor Rossing added.
Researchers at King’s will have the additional aim of evaluating whether there are potential differences between African-Caribbean and non-African-Caribbean people in kidney baseline measures as well as in treatment responses. This is relevant as recent work from King’s College London highlighted that African-Caribbean people with type 1 diabetes had a higher and faster risk of kidney disease progression which was independent of traditional risk factors.
To date there are no clinical trials in people with type 1 diabetes of African-Caribbean heritage who are often at higher risk of kidney complications of diabetes. This landmark study is a really important first milestone in this area and we are delighted to be involved as there is huge potential for new treatments that will make real clinical impact in an under-researched area of type 1 diabetes."Janaka Karalliedde, Clinical Reader in Diabetes and Cardiovascular Disease, King's College London
SGLT-2 inhibitors work by blocking the protein SGLT-2 in the kidneys. This protein usually helps the kidneys reabsorb glucose from urine that would otherwise be lost when it is excreted. As a result, when SGLT-2 is blocked, more glucose ends up in the urine and is removed from the body, helping patients with type 2 diabetes manage their condition more effectively. There are also glucose independent protective effects for the kidney and the heart with these medications which are now approved for the treatment of chronic kidney disease and heart failure in people with and without diabetes.
The trial has only been made possible due to the £1.3 million grant from JDRF. JDRF is a leading global type 1 diabetes charity that works to help people live better with the condition, prevent people from developing it and ultimately find cures. It does this by funding research, campaigning for access to all treatments and supporting those in the type 1 diabetes community.