Sotagliflozin Could Cut Clotting More Than Empagliflozin
Adults with type 2 diabetes and heart disease on SGLT2 drugs should note the early mouse-and-lab findings, which are not yet proven in patients.
Updated on Nov. 1, 2026 in Diabetes
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Researchers at Michigan Medicine and the University of Michigan Medical School reported in the Journal of Clinical Investigation on October 14, 2026, that the diabetes drug sotagliflozin reduced blood clot formation in mice more than empagliflozin did. The findings are preclinical and relevant mainly to researchers and clinicians following the drug class.
Why it matters
Sotagliflozin and empagliflozin are both used to manage cardiovascular risk in people with diabetes and heart disease, so understanding how they affect clotting could shape how clinicians think about their protective effects. The work offers a possible explanation for why sotagliflozin's cardiovascular benefits may differ from those of more selective drugs in the same class.
This preclinical study compared sotagliflozin and empagliflozin in mice with injured blood vessels and measured platelet activation in blood samples from healthy volunteers and people with type 2 diabetes. Sotagliflozin reduced clot formation by roughly 60% in the mice, while empagliflozin reduced it by only 5% to 10%, and the human findings are limited to lab measurements rather than patient outcomes.
The players
Michigan Medicine
The academic medical center of the University of Michigan, known for research across cardiology, diabetes, and kidney disease.
University of Michigan Medical School
A leading U.S. medical school whose researchers study cardiometabolic disease and drug mechanisms, and whose co-senior authors led this work.
The details
Sotagliflozin blocks two glucose transport proteins, SGLT2 and SGLT1, while empagliflozin primarily blocks SGLT2. The researchers found that sotagliflozin significantly suppressed excessive platelet activity, the cell fragments that drive clot formation, and that removing SGLT1 from mouse platelets alone cut clotting by about 40%, suggesting SGLT1 plays a role in the effect. The team has not yet worked out the full mechanism, and the effect has only been shown in laboratory and animal settings.
Timeline
October 14, 2026: The Journal of Clinical Investigation published the sotagliflozin platelet study.
Health Landscape
Empagliflozin's cardiovascular benefits, established in the EMPA-REG OUTCOME trial, made SGLT2 inhibitors a standard part of diabetes and heart-failure care. This study adds a mechanistic question to that landscape by suggesting that drugs with dual SGLT1 and SGLT2 activity may affect clotting differently than SGLT2-selective agents.
If you have type 2 diabetes or heart disease and take an SGLT2 inhibitor, this research is not a reason to change your medication. It is worth raising with your doctor if you want to understand how drugs in this class may differ in their effects on cardiovascular risk.
The takeaway
The key insight is that not all drugs in the same class work identically, and clotting may be one reason sotagliflozin's cardiovascular profile differs from empagliflozin's. Ask your physician whether drug-class differences like this are relevant to your own cardiovascular and diabetes care.
Further reading
For more on how these drugs fit into diabetes care, explore our Diabetes coverage.
Source note: This article includes information reported by SciTechDaily.
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