Slides
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1 Nasdaq: VTVT Hypoglycemia in Type 1 Diabetesand the Cadisegliatin Phase 3 ProgramVirtual KOL Event | October 20, 2026
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2 THE STATEMENTS MADE IN THIS PRESENTATION AND THE ACCOMPANYING ORAL COMMENTARYMAY INCLUDE FORWARD-LOOKING STATEMENTS REGARDING (I) THE DIABETES MARKET AND OTHER MARKETS, (II) THE DEVELOPMENT, CLINICAL TRIAL PROCESS, REGULATORY APPROVAL PROCESS AND ATTRIBUTES OF INVESTIGATIONAL AND MARKETED PRODUCTS TO TREAT THESE DISEASES AND OTHER CONDITIONS, (III) THE ECONOMIC POTENTIAL OF THOSE PRODUCTS AND (IV) THE FUTURE OPERATIONS,FUND-RAISINGACTIVITIES,EXPENDITURES,OPPORTUNITIES,AND FINANCIALPERFORMANCE OFVTVTHERAPEUTICS INC. FORWARD-LOOKING STATEMENTS INCLUDE ALL STATEMENTS THAT ARE NOT HISTORICAL FACTS AND CAN BE IDENTIFIED BY TERMS SUCH AS “ANTICIPATES, ” “BELIEVES, ” “COULD,” “ESTIMATES, ” “EXPECTS, ” “INTENDS, ” “MAY , ” “PLANS, ” “POTENTIAL, ” “PREDICTS, ” “PROJECTS, ” “SEEKS, ” “SHOULD, ” “TARGET, ” “WILL, ” “WOULD” OR SIMILAR EXPRESSIONS AND THE NEGATIVES OF THOSE TERMS.THESE FORWARD-LOOKING STATEMENTS ARE ONLY ESTIMATES BASED UPON THE INFORMATION AVAILABLE TO VTV THERAPEUTICS INC. (OR THE PARTY PREPARING SUCH FORWARD-LOOKING STATEMENTS) AS OF THE DATE OF THIS PRESENTATION. THE FORWARD-LOOKING STATEMENTS INCLUDED HEREIN INVOLVE KNOWN AND UNKNOWN RISKS AND UNCERTAINTIES AND OTHER IMPORTANT FACTORS SUCH THAT ACTUAL FUTURE OPERATIONS, OPPORTUNITIES, PRODUCT DEVELOPMENT PROCESSES AND OUTCOMES, CLINICAL TRIAL PROCESSES AND OUTCOMES, REGULATORY APPROVAL PROCESSES AND OUTCOMES, ECONOMIC PERFORMANCE OF PRODUCTS, FUND-RAISING ACTIVITIES AND FINANCIAL PERFORMANCE MAY DIFFER MATERIALLY FROM THOSE SET FORTH IN OR IMPLIED IN THESE FORWARD-LOOKING STATEMENTS. THESE RISKS, UNCERTAINTIES, AND OTHER FACTORS, WHICH MAY NOT BE WITHIN OUR CONTROL, ARE DISCUSSED IN MORE DETAIL IN OUR QUARTERLY,ANNUAL AND CURRENTREPORTS FILED WITH THE SECURITIES AND EXCHANGE COMMISSION, INCLUDING, WITHOUT LIMITATION, UNDER THE CAPTIONS, “RISK FACTORS,” “CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS” AND “MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS. ” THEREFORE, YOU SHOULD READ THIS PRESENTATION IN CONJUNCTION WITH SUCH MEANINGFUL CAUTIONARY STATEMENTS.UNDUE RELIANCE SHOULD NOT BE PLACED ON FORWARD-LOOKING STATEMENTS, WHICH SPEAK ONLY AS OF THE DATE HEREOF . EXCEPT AS REQUIRED BY LAW, WE EXPRESSLY DISCLAIM ANY RESPONSIBILITY TO PUBLICLY UPDATE OR REVISE OUR FORWARD-LOOKING STATEMENTS, WHETHER AS A RESULT OF NEW INFORMATION, FUTURE EVENTS OR OTHERWISE. ALL FORWARD-LOOKING STATEMENTS CONTAINED HEREIN ARE QUALIFIED IN THEIR ENTIRETY BY THE FOREGOING CAUTIONARY STATEMENTS.THIS PRESENTATION IS BEING PROVIDED TO YOU FOR INFORMATION PURPOSES ONLY . THIS PRESENTATION DOES NOT CONSTITUTE AN OFFER OR SALEOF(ORTHESOLICITATIONOFANOFFERTOBUY)ANYSECURITIESOFVTVTHERAPEUTICSINC.ORANYOF ITSSUBSIDIARIES.BY ACCEPTING THIS PRESENTATION, YOU ACKNOWLEDGE AND AGREE THAT (I) YOU WILL NOT RELY ON THIS PRESENTATION FOR MAKING ANY INVESTMENT DECISION WITH RESPECT TO ANY SECURITIES OF VTV THERAPEUTICS INC. OR ANY OF ITS SUBSIDIARIES, AND (II) ANY INVESTMENT DECISION MADE BY YOU WITH RESPECT TO ANY SUCH SECURITIES WILL BE BASED SOLELY ON AN OFFERING DOCUMENT RELATING TO SUCH SECURITIES (IF ANY), INCLUDING THE INFORMATION INCORPORATED BY REFERENCETHEREIN.
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3 AgendaSESSIONKEY TOPICS SPEAKERIntroductionPurpose of the event (problem of hypoglycemia) & introduction of speakers Paul SekhriChief Executive OfficerInevitability of Hypoglycemia in T1DCurrent practice/background; what is T1D?; incidence of T1D; SOC and treatment goals; drivers of hypoglycemia risk even with current device technologySchafer Boeder, MDParadigm Clinical Research & The University of California San DiegoImpact of Hypoglycemia on Daily & Long-Term LivingUnderestimation of hypoglycemia; patients impacted & how; clinical and social aspects of hypoglycemia; how hypoglycemia concerns impact HCP treatment adviceThe Lived Experience of Type 1 DiabetesDay in the life (carb. counting, insulin dosing decisions, device management, constant monitoring), quality of life, anxiety and fear of hypoglycemia, technology limitationsAlisa WeilersteinLiving with Type 1 DiabetesvTv Market ResearchReinforce KOL perspective with insights from market researchMartin LafontaineChief Commercial OfficerCadisegliatin & Phase 3 CATT1Glucokinase activation/MOA; Phase 2 data review; CATT1, CATT1 Hybrid designsKlara Klein, MD, PhDUniversity of North Carolina at Chapel Hill School of MedicineCorporate SummarySummary and upcoming events and catalystsPaul SekhriChief Executive OfficerQ&A and Concluding RemarksOpen floor Q&A with concluding remarksAll
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4 Featured Guest Speakers Schafer Boeder, MDHypoglycemia in T1DBoard-certified endocrinologist, Medical Director at Paradigm Clinical Research, and Associate Professor of Medicine at the University of California San Diego Alisa WeilersteinLiving with Type 1 DiabetesInternationally acclaimed cellist and 2011 MacArthur Fellow; living with type 1 diabetes since age nine Klara Klein, MD, PhDCadisegliatin & Phase 3 CATT1Assistant Professor, Division of Endocrinology and Metabolism, University of North Carolina at Chapel Hill, and Director of the Endocrine Diabetes and Obesity Clinical Research Unit (EnDO CRU)
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5 Hypoglycemia in T1DSchafer Boeder, MD
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The Persistent Burden of HypoglycemiaSevere events, frequent lows and daily lifein type 1 diabetesSchafer Boeder, MDEndocrinologist and clinical investigator, type 1 diabetesvTv Therapeutics Analyst & KOL Day · October 2026 70 mg/dL Independent clinical perspective. Views are the presenter’s own and do not represent vTv Therapeutics.
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Disclosures Clinical research fundingBiomea FusionCarmot TherapeuticsDexcomEli LillyLexicon Pharmaceuticals Novo NordiskPfizerREMD TherapeuticsStructure TherapeuticsvTv Therapeutics Consulting / AdvisoryCecelia Health Novo Nordisk Persperion Diagnostics Grant fundingNIHBreakthrough T1DDiabetes Research Connection This presentation is sponsored by vTv Therapeutics
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T1D is autoimmune loss of insulin production; about 2.1 million Americans with T1D depend on lifelong insulinImmune system attacks the beta cellsGenetic susceptibility plus environmental triggers; not caused by diet or lifestyle Insulin-producing beta cells are destroyedAutoantibodies often appear years before symptoms Absolute or near-absolute insulin deficiencyUntreated, this leads to diabetic ketoacidosis (DKA) Lifelong insulin replacementEvery meal, activity and night requires a dosing decision WHO LIVES WITH T1D 2.1 millionAmericans with diagnosed type 1 diabetes 1.8Madults aged 20+ (~86%)314Kchildren and adolescents under 20 9.5Mpeople with T1D worldwide in 2025, projected to reach 14.7M by 2040; the largest growth is among adults Sources: CDC National Diabetes Statistics Report (updated 2026; 2023 data); Ogle GD et al. Diabetes Res Clin Pract 2025;225:112277 (IDF Atlas 11th ed. / T1D Index v3.0);Holt RIG et al. ADA/EASD consensus report on the management of type 1 diabetes in adults. Diabetes Care 2026;49:1–42.
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CGM and automated insulin delivery have transformed care, yet many adults still miss glucose targetsSENSESContinuous glucose monitor (CGM)A small sensor under the skin reads glucose every few minutes and alarms when glucose is low or falling fast DELIVERSInsulin pumpDelivers rapid-acting insulin continuously through a small catheter; the user programs each dose ADJUSTSAutomated insulin delivery (AID)An algorithm links sensor and pump and raises or cuts insulin every few minutes. Meals and exercise must still be announced+ = 42%of adults using a 2nd generation AID, the most advanced systems studied, did not report an A1C of 7% or belowCGM VS. FINGERSTICK TESTING (24 STUDIES) −0.24%A1C (absolute)+5.6%time in range (absolute)−2.4%time below range (absolute) Sources: Holt RIG et al. Diabetes Care 2026 (ADA/EASD consensus; CGM meta-analysis); Wu Z, et al. Diabetes Obes Metab. 2026;28(2):1150–1159 (Canadian BETTER registry survey; second-generation AID, n=372; self-reported A1C). 42% calculated from 58.1% achieving A1C ≤7%.
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Tighter glucose control reduces long-term complications but raises the risk of hypoglycemiaIntensive insulin therapy lowers average glucose to reduce long-term risk, which moves people closer to the hypoglycemia edge Hypoglycemiabelow 70 mg/dLTarget range70–180 mg/dLHyperglycemiaabove 180 mg/dLHarm in minutes to hoursConfusion, seizure, loss of consciousness, falls and accidents Harm over yearsDamage to eyes, kidneys, nerves and blood vessels; DKA when insulin is missing INTENSIVE VS. CONVENTIONAL THERAPY IN THE DCCT (1,441 PEOPLE, ~6.5 YEARS)39–76% lower risk of eye, kidney and nerve complications2–3× higher rate of severe hypoglycemia Sources: DCCT Research Group. N Engl J Med 1993;329:977–986; Holt RIG et al. Diabetes Care 2026 (ADA/EASD consensus). Glucose thresholds per ADA/EASD CGM targets.
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Insulin injected under the skin cannot reproduce the timing of the pancreasInsulin still acting after the meal is absorbed 012345Hours after a meal Insulin effect Pancreaspeaks in 15–30 minInjected insulinpeak action ~2 h Schematic, not to scale Wrong routeThe pancreas releases insulin into the vein to the liver, which clears about 70% before it reaches the rest of the body Wrong timingInsulin injected under the skin is absorbed slowly, peaks around 2 hours and lingers for hours No recallOnce delivered, insulin cannot be removed. AID can stop giving more, but cannot take back what is already acting Source: Holt RIG et al. ADA/EASD consensus report on the management of type 1 diabetes in adults. Diabetes Care 2026 (section on alternative routes of insulin administration).
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T1D also impairs the body’s natural defenses against falling glucoseAS GLUCOSE FALLS TOWITHOUT DIABETESIN TYPE 1 DIABETES ~80 mg/dLPancreas stops releasing insulinLOSTInjected insulin keeps acting ~65–70 mg/dLPancreas releases glucagon, which tells the liver to release glucoseLOSTGlucagon response is typically lost within a few years of diagnosis ~65–70 mg/dLAdrenaline rises and raises glucoseREDUCEDOften blunted, especially after recent lows ~50–55 mg/dLWarning symptoms (shaking, sweating, hunger) prompt the person to eatREDUCEDCan be weak or absent: impaired awareness MEANWHILE, INSULIN NEEDS CHANGE HOUR BY HOUR WITHMealsExerciseSleepIllnessAlcoholStress and hormonesVariable absorption Glycemic thresholds are approximate. Sources: Cryer PE. Diabetes 2008;57:3169–3176 (counterregulation and hypoglycemia-associated autonomic failure);Holt RIG et al. Diabetes Care 2026 (ADA/EASD consensus).
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AID lowers hypoglycemia, but severe events persist among technology users 34% 18%17% No CGMCGMAID Adults with ≥1 severe hypoglycemic event in the past year, by technologyT1D Exchange online survey, 2021 (n=2,074)AMONG AID USERS 1 in 6reported a severe event in the past year SEVERE HYPOGLYCEMIA EMERGENCIES, US ADULTS 25.7201125.62020Adjusted rate per 1,000 person-years, claims-based study of 67,901 U.S. adults with T1D (2011–2020).No meaningful decline over a decade of new insulins and devices Severe hypoglycemia is self-reported (survey) or emergency/hospital-coded (claims), which likely undercounts events treated at home. Sources: Sherr JL et al. Diabetes Care 2024;47:941–947;McCoy RG, et al. Diabetes Care. 2023;46:e69–e71.
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Hypoglycemia is a spectrum; severe events are only its most visible part Level 3: severeNeeds another person’s help to recover Level 2: below 54 mg/dLClinically important hypoglycemia Level 1: below 70 mg/dLAlert threshold; take action Impaired awareness and fear-driven behaviorShape daily decisions; not captured by glucose thresholds ~1 hour a daybelow 70 mg/dL still meets the <4% consensus target~14 minutes a daybelow 54 mg/dL still meets the <1% target Levels per ADA/EASD and International Hypoglycaemia Study Group classification. Minutes calculated from 4% and 1% of 24 hours. Source: Holt RIG et al. Diabetes Care 2026 (ADA/EASD consensus).
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Four clinically meaningful hypoglycemia burdensCURRENT EXPOSUREFrequent Level 2Below 54 mg/dL daily, almost daily or a few times per weekWhy it mattersImpairs thinking during episodes; repeated lows blunt defenses 25% surveyPublished: No directly comparable published estimate found HISTORYPrior severe (Level 3)At least one episode in the past year that needed another person’s helpWhy it mattersStrongest predictor of the next severe event 15% surveyPublished: 20% in T1D Exchange survey PHYSIOLOGYImpaired awarenessRarely or never feels the warning symptoms of a lowWhy it mattersRaises severe-event risk; first sign may be confusion 18% surveyPublished: 25–30% (ADA/EASD consensus) BEHAVIORFear-driven avoidanceA1C above 7% and strongly agrees they keep glucose high, or can’t aim lower, because of lowsWhy it mattersTrades hypoglycemia risk today for complication risk later 46%* surveyPublished: 43% reported fear as a barrier to glycemic targets (adult T1D study; different definition)These groups overlap. Percentages describe each group separately and cannot be added together. *Share of adults with A1C >7%. Survey: dQ&A online panel of US adults with T1D, Jul–Aug 2025 (n=674), self-reported; sponsored by vTv Therapeutics (IHSG 2026 presentation).Published: Sherr JL et al. Diabetes Care 2024;47:941–947; Holt RIG et al. Diabetes Care 2026; Talbo et al. Endocrine Practice. 2026;32(5):720–727.
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Removing the overlap, about two-thirds of adults with T1D carry at least one clinically meaningful hypoglycemia burden 24%+11%+10% +20%65% Frequent L2+ Prior L3+ IAH+ AvoidanceAny burden Adults with T1D with ≥1 clinically meaningful direct or indirect hypoglycemia burden, each person counted onceWeighted for A1C distribution IAH, impaired awareness of hypoglycemiaSurvey: dQ&A online panel of US adults with T1D, Jul–Aug 2025 (n=674; 64% AID, 31% MDI+CGM, 5% MDI); self-reported; sponsored by vTv Therapeutics.Sources: Bell T et al., IHSG Advances in Hypoglycemia 2026.A1C weighting per Ebekozien O, et al. Longitudinal trends in glycemic outcomes and technology use for over 48,000 people with type 1 diabetes (2016–2022) from the T1D exchange quality improvement collaborative. Diab Technol Ther 2023 Nov;25(11):765-73. HOW EACH PERSON IS COUNTED ONCE 1Frequent Level 2 lows?Yes: counted in the first bar 2If not: severe event in past year?Yes: counted in the second bar 3If neither: impaired awareness?Yes: counted in the third bar 4If none: A1C above 7% and strong avoidance?Yes: counted in the fourth bar
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Removing the overlap, about half of adults with T1D on AID carry at least one clinically meaningful burden 22%+8%+10% +14%54% Frequent L2+ Prior L3+ IAH+ AvoidanceAny burden Adults with T1D on AID with ≥1 clinically meaningful direct or indirect hypoglycemia burden, each person counted onceWeighted for A1C distributionHOW EACH PERSON IS COUNTED ONCE 1Frequent Level 2 lows?Yes: counted in the first bar 2If not: severe event in past year?Yes: counted in the second bar 3If neither: impaired awareness?Yes: counted in the third bar 4If none: A1C above 7% and strong avoidance?Yes: counted in the fourth bar IAH, impaired awareness of hypoglycemiaSurvey: dQ&A online panel of US adults with T1D using AID, Jul 17–Aug 1, 2025 (n=429 of 674); self-reported; sponsored by vTv Therapeutics. Source: Bell T, et al. Breakthrough T1D Clinical & Research Congress 2026.A1C weighting per Wu Z, et al. Diabetes Obes Metab. 2026;28(2):1150-1159 (BETTER registry analysis).
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Hypoglycemia shapes the whole day, not just the minutes of an episode NIGHTSleepLows during sleep are often missed or wake the person and family; the next day starts tired BEFORE DRIVINGDrivingGlucose must be checked and safe before getting behind the wheel WORKDAYWorkA low slows thinking and speech and interrupts meetings, exams and shifts AFTER WORKExerciseActivity needs planning: less insulin, extra carbohydrate, lows hours later EVENINGS AND TRAVELSocial lifeMeals out, alcohol, time zones and new routines all raise risk AROUND THE CLOCKConstant vigilanceChecking the CGM and making dosing and food decisions many times a dayAlways preparedCarrying fast-acting glucose and glucagon everywhereShared burdenPartners and parents follow alerts remotely and wake at night Clinical synthesis. See Holt RIG et al. Diabetes Care 2026 (ADA/EASD consensus: driving, employment, exercise, psychosocial care); Chatwin H et al. J Diabetes Complications (YourSAY: Hypoglycemia).
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Fear of hypoglycemia is often a learned, rational response, and it pulls glucose higherA frightening lowAt night, in public, or while driving Fear of the next oneA learned, often rational response Protective behaviorRun higher, snack defensively, cut doses, skip exercise Fewer lows, higher A1CThe strategy ‘works’ , so it persists Holt RIG et al. Diabetes Care 2026;49:1–42 (ADA/EASD consensus). Talbo et al. Endocrine Practice. 2026;32(5):720–727. FEAR AS A BARRIER 43%of adults with T1D said fear of hypoglycemia keeps them from reaching optimal glucose levelsOnline registry of adults with T1D (n=1,437); single screening question +0.48% higher A1C on averagein those who saw fear as a barrier, after adjustment
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Recurrent lows blunt the warning system; acute harms are established, long-term effects less certainTHE IMPAIRED-AWARENESS CYCLE Recurrent lowsEspecially Level 2 lowsBlunted defensesAdrenaline and symptoms start at lower glucose Impaired awarenessFirst sign may be confusion~6× more severe eventsCompared with intact awareness Partly reversibleSeveral weeks of strictly avoiding lows can restore warning symptoms in many people; CGM alerts help CONSEQUENCES, BY STRENGTH OF EVIDENCEESTABLISHED•Impaired thinking, judgment and coordination during episodes•Seizure or loss of consciousness in severe events•Falls, injuries and driving accidents•Acute cardiac effects, including altered heart rhythmASSOCIATED•Higher cardiovascular events and mortality after severe episodes; causality not proven•Estimated >8% of deaths in people with T1D under 56•Small cognitive decrements after decades of severe events (DCCT-EDIC, 32 years) Sources: Gold AE et al. Diabetes Care 1994;17:697–703; Cranston I et al. Lancet 1994;344:283–287; International Hypoglycaemia Study Group. Lancet Diabetes Endocrinol 2019;7:385–396;Holt RIG et al. Diabetes Care 2026 (ADA/EASD consensus: mortality estimate and DCCT-EDIC cognition findings).
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The burden is broadFrequent Level 2, prior severe events, impaired awareness and fear-driven avoidance: up to 65% of adults in a 2025 survey Technology has helped reduce the hypoglycemia problem, but has not removed it1Hypoglycemia is intrinsic to insulin replacementInjected insulin cannot switch off, and T1D removes the body’s own defenses 2 Technology has helped reduce the problemCGM and AID reduce lows, yet ~54% AID of users still report at least one clinically meaningful hypoglycemia burden3 4Hypoglycemia shapes behavior and controlAvoiding lows keeps glucose higher, trading safety today for complication risk later CGM and AID have transformed type 1 diabetes care, but they have not removed the burden of hypoglycemia. Its clinical burden reaches well beyond severe events.Survey figures: dQ&A 2025 online panel (n=674), sponsored by vTv Therapeutics; accepted/submitted abstracts, pending compliance review. Other sources as cited on preceding slides.
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22 The Lived Experience of Type 1 DiabetesAlisa Weilerstein
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23 vTv Market ResearchMartin Lafontaine
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24 TOOMUCHINSULIN TOOLITTLEINSULIN Living with T1D is Like Driving on a Narrow, Slippery and Dangerous Road Hyperglycemia: cumulative, long-term organ damage Hypoglycemia: immediate neurologic damage !
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25 Hypoglycemia is commonin people with T1D and most have several mild to moderate events perweek6 Hypoglycemic events range fromlife-disruptive tolife-threateningHypoglycemia is the most important limitingfactor in the glycemicmanagement of T1D5 ~9.5M people living with T1D globally in 2025, expected to grow to 14.7M by 20403 By not achieving the ADA recommended target of HbA1c <7.0%, people with T1D are exposed to an increased risk of diabetes-related complications5 Since insulin was discovered in 1921,no oraladjunctive therapy (one injectable) to treat T1D has been approved in the U.S. ~2Mwith type 1 diabetes in the U.S.1,2 ~75%with T1D fail to lower their blood glucose to achieve target HbA1c4 0Oral adjunctive therapiesfor T1D Cadisegliatin: A Large Opportunity in a Long-Underserved Market 1: Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2026 update (2023 estimates). Last accessed on October 6, 2026.; 2: Smith RA, et al. We are on the verge of breakthrough cures for type 1 diabetes, but who are the 2 million Americans who have it? J Health Econ Outcomes Res 2024;11(2):145–153.;3: Type 1 Diabetes Index, Last accessed on May 8, 2026.; 4: Ebekozien O, et al. Longitudinal trends in glycemic outcomes and technology use for over 48,000 people with type 1 diabetes (2016–2022) from the T1D exchange quality improvement collaborative. Diab Technol Ther 2023 Nov;25(11):765-73.; 5: The management of T1D Adults. The Updated 2026 Consensus by the American Diabetes Association (ADA) and the European Study for Diabetes (EASD).; 6: Breakthrough T1Dwebsite. Last accessed on February 20, 2026.
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26 Current Therapy Landscape – US T1D 1: Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2026 update (2023 estimates). Last accessed on October 6, 2026.; 2: Smith RA, et al. We are on the verge of breakthrough cures for type 1 diabetes, but who are the 2 million Americans who have it? J Health Econ Outcomes Res 2024;11(2):145–153.; 3: Insulet Corporation. Investor Presentation, September 2026 (slide 17); Tandem Diabetes Care. Company Overview, August 6, 2026 (page 4); Beta Bionics. Corporate Presentation, September 2026 (slide 6); company estimates. People counts calculated (~2 million × share) and rounded.; 4: Estimate derived from the 40% using AID subtraction from 100% of T1D using insulin.; 5: Derived calculation from 2M people with T1D to which is applied the percentage of MDI and Pump/AID users. ~2 million US people with T1D1,2, by insulin delivery method ~2MUS people with T1D ~60%Multiple Daily Injections, CGM or BGM4~1.2 million people5 ~40%Pump/AutomatedInsulin Delivery3~800,000 people5 No oral FDA-approved adjunct therapy to insulin to manage blood glucose in T1D
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27 T1D INDIVIDUALSPERSPECTIVEWhat people living with type 1 diabetes say about low blood glucose Hypoglycemia Burden: Beyond the Frequency or Severity of EpisodesIn a recent survey1 with 702 US Adults living with T1D: 88%strongly agree or somewhat agree with the sentence: "I hate having low blood glucose." 87%of adults with T1D with an HbA1C >7% strongly agree or somewhat agree to often keeping their blood glucose higher than they should to avoid lows, or that they would aim for lower blood glucose if it was not for the risk of hypoglycemia 85% Hypoglycemia is the most important limiting factor in the glycemic management of T1D2ADA/EASD 2026 Consensus Report on the Management of T1D in Adults of adult AID users with an HbA1C >7% strongly agree or somewhat agree to often keeping their blood glucose higher than they should to avoid lows, or that they would aim for lower blood glucose if it was not for the risk of hypoglycemia 1: vTv Data on File, dQ&A Consumer Market Research, 2025 (N=702). For presentation purposes only: findings reflect a survey of 702 respondents and should not be generalized to the entire T1D population. 88%: all respondents (N=702). 87% and 85%: only respondents with available HbA1c data and HbA1c >7.0% (n=185 and AID users n=102, respectively). Survey questions: "When thinking about your experiences with hypoglycemia, how much do you agree or disagree with the following statements?" (Strongly disagree – Strongly agree, 5-point scale). I hate having low blood glucose. I often keep my blood glucose higher than I should to avoid lows. If it were not for the risk of hypoglycemia, I would aim for lower blood glucose; 2: The Management of T1D in Adults. The Updated 2026 Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). September 2026.
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28 ENDOCRINOLOGISTSPERSPECTIVEWhat US adult endocrinologists say and think about hypoglycemia Hypoglycemia is a Top Priority and Concern for EndocrinologistsIn a recent survey1 with 45 US Adult Endocrinologists treating people with T1D: 85%said that the short-term risk of hypoglycemia is an equal or higher treatment priority than the long-term hyperglycemia risk for most of their T1D patients 78%strongly agree or agree that avoiding hypoglycemia is a significant challenge in managing their T1D patients 86%strongly agree or agree that fear of hypoglycemia significantly interferes with patients trying to achieve an HbA1c < 7.0% (53 mmol/mol) 1: dQ&A EU and US Endocrinologists Market Research. Data on file. 2026. N=45 US Adult Endocrinologists. For presentation purposes only: findings reflect a survey of 45 US endocrinologists and should not be generalized to the entire endocrinologist population. Survey questions: Q1: How do you balance long-term hyperglycemia risk vs. short-term hypoglycemia risk when setting treatment priorities for your T1D patients? Long-term risks from hyperglycemia are significantly more important / Long-term risks from hyperglycemia are slightly more important, both have equal importance / Short-term risks from hypoglycemia are slightly more important / Short-term risks from hypoglycemia are significantly more important. Q2: How much do you agree or disagree with statements about hypoglycemia and your T1D patients? (Strongly disagree – Strongly agree, 5-point scale) Avoiding hypoglycemia is a significant clinical challenge in managing my patients. Q3: Fear of Hypoglycemia significantly interferes with patients achieving an HbA1C < 7.0% (53mmol/mol) (Strongly disagree – Strongly agree, 5-point scale); 2: The Management of T1D in Adults. The Updated 2026 Consensus Report by the American Diabetes Association (ADA) and the European Study for Diabetes (EASD) September 2026. Hypoglycemia is the most important limiting factor in the glycemic management of T1D2ADA/EASD 2026 Consensus Report on the Management of T1D in Adults
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29 Reducing the Risk of Hypoglycemia Total Addressable Market in T1D (TAM) •Hypoglycemia risk is an inherent risk to disease management in practically all individuals with T1D as exogenous insulin is not subject to the body’s normal feedback mechanisms1,2 •Real-world prevalence data show that hypoglycemia exposure is near-universal, not occasional, with most individuals with T1D having severalepisodes of mild-to-moderate hypoglycemia events each week3,4,5 Virtually ALLindividuals with T1D 1: Cryer PE."Elimination of Hypoglycemia From the Lives of People Affected by Diabetes."Diabetes. 2011;60(1):24–27.; 2: McCrimmon RJ, Sherwin RS. Hypoglycemia in type 1 diabetes. Diabetes. 2010 Oct;59(10):2333-9.; 3: Khunti K, Alsifri S, Aronson R, Cigrovski Berković M, Enters-Weijnen C, Forsén T, Galstyan G, Geelhoed-Duijvestijn P, Goldfracht M, Gydesen H, Kapur R, Lalic N, Ludvik B, Moberg E, Pedersen-Bjergaard U, Ramachandran A; HAT Investigator Group. Rates and predictors of hypoglycaemia in 27 585 people from 24 countries with insulin-treated type 1 and type 2 diabetes: the global HAT study. Diabetes Obes Metab. 2016 Sep;18(9):907-15.; 4: Self-reported hypoglycemia in insulin-treated patients with diabetes: Results from an international survey on 7,289 patients from nine countries."Diabetes Research and Clinical Practice, 20176.; 5: Breakthrough T1D website, last accessed September 21, 2026. Note: "Virtually all" reflects that nearly all adults with T1D are candidates for a therapy that may reduce hypoglycemia risk; a small subset (e.g., contraindications, those having received pancreatic transplant) may fall outside the addressable population. Our belief: virtually all individuals with T1D, independent of technology
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Removing the overlap, about two-thirds of adults with T1D carry at least one clinically meaningful hypoglycemia burden 24%+11%+10% +20%65% Frequent L2+ Prior L3+ IAH+ AvoidanceAny burden Adults with T1D with ≥1 clinically meaningful direct or indirect hypoglycemia burden, each person counted onceWeighted for A1C distributionHOW EACH PERSON IS COUNTED ONCE 1Frequent Level 2 lows?Yes: counted in the first bar 2If not: severe event in past year?Yes: counted in the second bar 3If neither: impaired awareness?Yes: counted in the third bar 4If none: A1C above 7% and strong avoidance?Yes: counted in the fourth bar 30 IAH, impaired awareness of hypoglycemiaSurvey: dQ&A online panel of US adults with T1D, Jul–Aug 2025 (n=674; 64% AID, 31% MDI+CGM, 5% MDI); self-reported; sponsored by vTv Therapeutics.Sources: Bell T et al., IHSG Advances in Hypoglycemia 2026.A1C weighting per Ebekozien O, et al. Longitudinal trends in glycemic outcomes and technology use for over 48,000 people with type 1 diabetes (2016–2022) from the T1D exchange quality improvement collaborative. Diab Technol Ther 2023 Nov;25(11):765-73.
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Removing the overlap, about half of adults with T1D on AID carry at least one clinically meaningful burden 22%+8%+10% +14%54% Frequent L2+ Prior L3+ IAH+ AvoidanceAny burden Adults with T1D on AID with ≥1 clinically meaningful direct or indirect hypoglycemia burden, each person counted onceWeighted for A1C distributionHOW EACH PERSON IS COUNTED ONCE 1Frequent Level 2 lows?Yes: counted in the first bar 2If not: severe event in past year?Yes: counted in the second bar 3If neither: impaired awareness?Yes: counted in the third bar 4If none: A1C above 7% and strong avoidance?Yes: counted in the fourth bar 31 IAH, impaired awareness of hypoglycemiaSurvey: dQ&A online panel of US adults with T1D using AID, Jul 17–Aug 1, 2025 (n=429 of 674); self-reported; sponsored by vTv Therapeutics. Source: Bell T, et al. Breakthrough T1D Clinical & Research Congress 2026.A1C weighting per Wu Z, et al. Diabetes Obes Metab. 2026;28(2):1150-1159 (BETTER registry analysis).
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32 US Adult Endocrinologists likelihood to Recommend a Hypoglycemia-Reducing Therapy Across All Four Hypoglycemia Burden Segments1How likely would you be to recommend a once daily oral adjunct therapy to insulin to your Type 1 patients who fit the following criteria? (Definitely / Likely / Unlikely / Definitely not). Potential benefits include a -30% reduction in the combined Level 2 and severe hypoglycemia events-No change in HbA1c or Time-In-Range (no improvement or no worsening in patients with an average HbA1c of 7.5% at baseline)-A 5% Insulin Daily Dose reduction. -Respondents were also given a quick explainer on the MOA and were told to assume the therapy was generally well tolerated with no additional risks of weight gain, nausea, diabetic ketoacidosis (DKA) or high cholesterol compared to only using insulin, and that the therapy would be covered by insurers. DefinitelyLikelyUnlikelyDefinitely not Highly Impacted by L2 Hypoglycemia (2+ L2 events in a typical week)38% 89%would definitely/likely recommend History of Severe (L3) Hypoglycemia 49% 96%would definitely/likely recommend Documented Hypoglycemia Unawareness (IAH)36% 58% 94%would definitely/likely recommend Exhibits Hypoglycemia Avoidance Behaviors (And HbA1C >7%)31% 53% 84%would definitely/likely recommend 1: 2026 dQ&A US Adult Endocrinologists Market Research. vTv Data on file. N=45 US Adult Endocrinologists. For presentation purposes only: findings reflect a survey of 45 US adult endocrinologists and should not be generalized to the entire endocrinologist population. NOTE: Combined % = definitely + likely would recommend. 51% 47%
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33 Cadisegliatin and the Phase 3 CATT1 ProgramKlara Klein, MD, PhD
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Klara Klein, MD, PhDAssistant Professor, Division of Endocrinology and Metabolism Director, Endocrine, Diabetes, and Obesity Clinical Research Unit Cadisegliatin as an adjunctive therapy to insulin in people living with type 1 diabetes
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Disclosures•I have consulted for Antag Therapeutics, Corxel, Eli Lilly and Company, Novo Nordisk, Pfizer, Roche Pharmaceuticals, and vTv Therapeutics. •I received research related contracts (paid to the institution) from Bayer, Boehringer-Ingelheim, Carmot, Diasome, Gentibio, Eli Lilly and Company, Novo Nordisk, Rhythm Pharmaceuticals, Roche Pharmaceuticals, and vTv Therapeutics.
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Objectives•Overview of cadisegliatin mechanism of action•Review of cadisegliatin Phase 2 data•Outline of ongoing and upcoming cadisegliatin trials
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Glucokinase (GK) is a molecular glucose sensor GKB insulin Glucose Glucoseinsulin Glucose-6P Glucosemetabolism Liver Hepatocyte Pancreatic b-cell GKLGlucoseGlucose-6P
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Glucokinase (GK) is a molecular glucose sensor GKB insulin Glucose insulin Glucose-6P Glucosemetabolism Liver Hepatocyte Pancreatic b-cell Glucose GKLGlucoseGlucose-6P
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Glucokinase (GK) is a molecular glucose sensor Glucokinase Hexokinase GKB insulin Glucose Glucoseinsulin Glucose-6P Glucosemetabolism Liver Hepatocyte Pancreatic b-cell GKLGlucoseGlucose-6P
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Hepatic GK has unique properties GKL GKB insulin Glucose Glucose Glucoseinsulin Glucose-6P Glucosemetabolism Glucose-6PLiver Hepatocyte Pancreatic b-cell
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GKL GKB insulin Glucose Glucose Glucoseinsulin Glucose-6P Glucosemetabolism Glucose-6PGKRPLiver Hepatocyte Pancreatic b-cell Hepatic GK has unique properties
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GKL GKB insulin Glucose Glucose Glucoseinsulin Glucose-6P Glucosemetabolism Glucose-6PGKRPLiver Hepatocyte Pancreatic b-cell Modified from: Sternisha and Miller. Arch of Biochem and Biophys. 2019. Hepatic GK has unique properties
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GKL GKB insulin Glucose Glucose Glucoseinsulin Glucose-6P Glucosemetabolism Glucose-6P Increased glucose metabolism/storageGKRPLiver Hepatocyte Pancreatic b-cell Hepatic GK has unique properties Modified from: Sternisha and Miller. Arch of Biochem and Biophys. 2019.
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GKL GKB insulin Glucose Glucose Glucoseinsulin Glucose-6P Glucosemetabolism Glucose-6P Increased glucose metabolism/storageGKRPLiver Hepatocyte Pancreatic b-cell Hepatic GK has unique properties GKA Modified from: Sternisha and Miller. Arch of Biochem and Biophys. 2019.
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GKL GKB insulin Glucose Glucose Glucoseinsulin Glucose-6P Glucosemetabolism Glucose-6P Increased glucose metabolism/storageGKRPLiver Hepatocyte Pancreatic b-cell TTP399 Liver-selective GK activation shows promise for diabetes *Cadisegliatin is also known as TTP399 TTP399 is designed to activate GK in the liver TTP399 did not activate GK in ß-cells Vella A, et al. Sci Transl Med. 2019.
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GKL GKB insulin Glucose Glucose Glucoseinsulin Glucose-6P Glucosemetabolism Glucose-6P Increased glucose metabolism/storageGKRPLiver Hepatocyte Pancreatic b-cell TTP399 Liver-selective GK activation shows promise for diabetes *Cadisegliatin is also known as TTP399 TTP399 is designed to activate GK in the liver TTP399 did not activate GK in ß-cells TTP399 did not disrupt the interaction between GK and GKRP (GK Regulatory Protein) keeping physiological control of GKGKRPGKL Vella A, et al. Sci Transl Med. 2019.
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Phase 1(Sentinels) March 2018 Study design §Open-label§7 days dose escalation up to 1200mg QD§5 adult participants with T1D on CSII and CGM(1) §Primary Goal: Safety and determine dosing TTP399-203 (SimpliciT1): Adaptive Phase 1b/2 Study Trial Design 1 site – Note: ClinicalTrials.gov Identifier: NCT03335371. (1)Continuous Subcutaneous Insulin Infusion (CSII) and Continuous Glucose Monitoring (CGM). Part 1 required CGM and CSII. Participants on multiple daily injections and self monitored blood glucose with capillary glucose meter were not excluded in Part 2.
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Phase 1(Sentinels)Phase 2(Part 1) March 2018June 2019 Study design §Open-label§7 days dose escalation up to 1200mg QD§5 adult participants with T1D on CSII and CGM(1) §Primary Goal: Safety and determine dosing §Randomized, Double-blind, Placebo control§Treat to target design§12 weeks Oral dosing 800mg/placebo§19 adult participants with T1D on CSII and CGM(1) §Primary Endpoint: Δ in HbA1c TTP399-203 (SimpliciT1): Adaptive Phase 1b/2 Study Trial Design 1 site – 4 sites - Note: ClinicalTrials.gov Identifier: NCT03335371. (1)Continuous Subcutaneous Insulin Infusion (CSII) and Continuous Glucose Monitoring (CGM). Part 1 required CGM and CSII. Participants on multiple daily injections and self monitored blood glucose with capillary glucose meter were not excluded in Part 2.
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Phase 1(Sentinels)Phase 2(Part 1)Phase 2 (Part 2) March 2018June 2019February 2020 Study design §Open-label§7 days dose escalation up to 1200mg QD§5 adult participants with T1D on CSII and CGM(1) §Primary Goal: Safety and determine dosing §Randomized, Double-blind, Placebo control§Treat to target design§12 weeks Oral dosing 800mg/placebo§19 adult participants with T1D on CSII and CGM(1) §Primary Endpoint: Δ in HbA1c §Randomized, Double-blind, Placebo control§Treat to target design§12 weeks Oral dosing 800mg/placebo §85 adult participants with T1D (all comers)§Primary Endpoint: Δ in HbA1c Note: ClinicalTrials.gov Identifier: NCT03335371. (1)Continuous Subcutaneous Insulin Infusion (CSII) and Continuous Glucose Monitoring (CGM). Part 1 required CGM and CSII. Participants on multiple daily injections and self monitored blood glucose with capillary glucose meter were not excluded in Part 2. TTP399-203 (SimpliciT1): Adaptive Phase 1b/2 Study Trial Design 1 site – 4 sites - 13 sites -
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SimpliciT1: Adaptive Phase 1b/2 Study Trial Design N=104: N=19 for Part 1 and N=85 for Part 2Modified from: Klein, et al. Diabetes Care. 2021.
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TTP399 improved glycemic control in both Part 1 and Part 2 Part 1N=19; CSII + CGM Modified from: Klein, et al. Diabetes Care. 2021.
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TTP399 improved glycemic control in both Part 1 and Part 2 Part 1N=19; CSII + CGM Part 2N=85; MDI or CSII +/- CGM Klein, et al. Diabetes Care. 2021.
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A reduction in hypoglycemia and ketosis events was noted Hypoglycemia events (N = 45)(N = 40) Klein, et al. Diabetes Care. 2021.
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A reduction in hypoglycemia and ketosis events was noted Hypoglycemia events Ketosis events* *Data shown is a meta-analysis from Part 1 and Part 2. (N = 45) (N = 54)(N = 46)(N = 40) Klein, et al. Diabetes Care. 2021.
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Cadisegliatin did not increase ketosis risk during insulin withdrawal Phase 1 insulin withdrawal study (N=23) in T1D participantsKlein and Boeder, et al. Diab Obes Metab. 2022.
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…with signals for improved ketosis risk Klein and Boeder, et al. Diab Obes Metab. 2022.
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Cadisegliatin improved glycemia with a reduction in hypoglycemia and no evidence of increased risk of ketosis.What’s next? From two completed studies: Phase 2 SimpliciT1 study & Phase 1 insulin withdrawal study
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58 Cadisegliatin Phase 3 CATT1 Study* – Informed by FDA Advice and Published Guidance for Endpoint Selection, Exposure, and Population Criteria *NCT06334133; **US Food and Drug Administration. Diabetes Mellitus: Efficacy Endpoints for Clinical Trials Investigating Antidiabetic Drugs and Biological Products. Guidance for Industry. FDA Draft Guidance (May 2023). CATT1 StudyT1DM patients on CGM but not AIDEnrollment completed:166 participants randomized Primary endpoint:Incidence of Level 2 (based on study CGM) and Level 3 (based on blinded clinical adjudication)hypoglycemic eventsKey secondary endpoint:Change in Hemoglobin A1cScreen & Lead-inIncludes 4-week baseline assessment Randomization Primaryendpoint:Hypoglycemia @26weeks TTP399: 800 mg once daily TTP399: 800 mg twice daily Insulin Alone 26 weeks8-12 weeks R CATT1 will usecontinuous glucose monitoring (CGM) to measure reduction of hypoglycemic events in accordance with the FDA draft guidance issued in 2023 on diabetes-related clinical trials**
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Insulin alone (6 weeks) TTP399 800 mg QD (6 weeks) TTP399 800 mg QD (6 weeks) Insulin alone (6 weeks) *NCT07616206 Hybrid CATT1 will inform the design and operational aspects of future phase 3 research 2-week wash-out Endpoints include: CGM metrics: TIR, TAR, TBRGlucose excursion after a mixed meal tolerance test 2-4 weeks R Screen and lead-in Period Cadisegliatin Phase 2a Hybrid CATT1 Study* T1DM patients on CGM and AID (hybrid closed loop)Targetenrollment:40 subjects
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Summary results from two completed clinical studies ofcadisegliatin in type 1 diabetes •HbA1c reduction between 0.3-0.7%
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•HbA1c reduction between 0.3-0.7% •No evidence of increased risk for DKA Summary results from two completed clinical studies ofcadisegliatin in type 1 diabetes
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•HbA1c reduction between 0.3-0.7% •No evidence of increased risk for DKA•Reduction in hypoglycemia•Phase 3 study (target N=150) currently underway (CATT1) Summary results from two completed clinical studies ofcadisegliatin in type 1 diabetes
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•HbA1c reduction between 0.3-0.7% •No evidence of increased risk for DKA•Reduction in hypoglycemia•Phase 3 study (target N=150) currently underway (CATT1)•Well-tolerated Summary results from two completed clinical studies ofcadisegliatin in type 1 diabetes
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64 Corporate SummaryPaul Sekhri
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651: Ebekozien O, et al. Longitudinal Trends in Glycemic Outcomes and Technology Use for Over 48,000 People with Type 1 Diabetes (2016-2022) from the T1D Exchange Quality Improvement Collaborative. Diabetes Technol Ther. 2023 Nov;25(11):765-773. doi: 10.1089/dia.2023.0320. Epub 2023 Oct 16. PMID: 37768677. ; 2:Holt RIG, et al. The Management of Type 1 Diabetes in Adults. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2021 Nov;44(11):2589-2625. doi: 10.2337/dci21-0043. Epub 2021 Sep 30. PMID: 34593612. Corporate Summary01Late-stage assetCadisegliatin, currently in Phase 3 development, has the potential to become the first oral adjunctive therapy for type 1 diabetes (T1D) in the U.S.; CATT1 enrollment is complete, with topline results expected mid-2027; Phase 2a Hybrid CATT1 study in T1D patients using hybrid closed-loop insulin delivery systems expected to initiate before year-end 2026 02Significant unmet need and commercialopportunity~75% of people living with T1D in the U.S. do not achieveADA recommended blood glucose levels (HbA1c <7%), with hypoglycemia being the major limiting factorin the glycemic management of T1D and type 2 diabetes (T2D)1,2 03Experienced leadershipLed by seasoned biopharma executives with a strong track record of advancing novel therapies for metabolic diseases and diabetes 04Strong balance sheet$86.6M cash (at 6/30/2026) provides runway well past the CATT1 topline data readout 05Deep pipeline of differentiated assetsAdditional clinical-stage assets in immunology/inflammation, metabolism, andoncology disease areas present opportunities for significant non-dilutive funding
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66 Q&A and Concluding Remarks
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67 Thank you!Contact us: jfraunces@lifesciadvisors.com