Table 1

Eligibility criteria

Inclusion criteriaExclusion criteria
  • Clinical diagnosis of T2DM.

  • Age ≥30 and ≤80 years.

  • Currently treated with one or two classes of oral glucose-lowering therapy (given either as separate or combined medications), that do not include a DPP4 inhibitor, a SGLT2 inhibitor or a thiazolidinedione.

  • Diabetes duration ≥12 months.

  • No change in diabetes treatment (new treatments or dose change) within previous 3 months.

  • HbA1c > 58 mmol/mol (>7.5%) and ≤110 mmol/mol (≤12.2%).

  • eGFR ≥60 mL/min/1.73 m².

  • Able and willing to give informed consent.

  • Changes in glucose-lowering therapy or dose within last 3 months.

  • ALT >2.5×upper limit of the assay normal range or known liver disease, specifically bilirubin >30 μmol/L that is associated with other evidence of liver failure.

  • Insulin treated within the last 12 months.

  • Treated with study drugs within the last 3 months.

  • Limb ischaemia shown by absence of both pulses in one or both feet.

  • Currently treated with corticosteroids.

  • Currently treated with rifampicin, gemfibrozil, phenytoin and carbamazepine.

  • Active infection (any infection requiring antibiotics).

  • Foot ulcer requiring antibiotics within previous 3 months.

  • Recent (within 3 months) significant surgery or planned surgery (excluding minor procedures).

  • Acute cardiovascular episode (angina, myocardial infarction, stroke, transient ischaemic episode) occurring within the previous 3 months.

  • History of heart failure.

  • Current use of loop diuretic therapy (furosemide or bumetanide).

  • History of bladder carcinoma.

  • Current/ongoing investigation for macroscopic haematuria.

  • History of diabetic ketoacidosis.

  • History of pancreatitis.

  • Pregnant, breastfeeding or planning a pregnancy over the study period.

  • Concurrent participation on another Clinical Trial of an Investigational Medicinal Product (CTIMP) where the IMP is currently being taken, or without sufficient washout period (five times the longest half-life of the study IMPs) and without consultation with the CTIMP research team.

  • Unable or unwilling to give informed consent.

  • Females of childbearing potential must be willing to use an effective method of contraception from the time consent is signed until 7 days after treatment discontinuation. A negative pregnancy test is required within 7 days prior to treatment initiation and will be required for continuation at each study visit.

  • ALT, alanine aminotransferase; DPP4, dipeptidyl peptidase‐4; eGFR, estimated glomerular filtration rate; HbA1c, glycated haemoglobin; SGLT2, sodium-glucose co-transporter-2; T2DM, type 2 diabetes mellitus.