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. 2024;33(6):569-577.
doi: 10.1159/000540852. Epub 2024 Aug 12.

Acute Effect of Imeglimin Add-on Therapy on 24-h Glucose Profile and Glycemic Variability in Patients with Type 2 Diabetes Receiving Metformin

Yasutake Shinohara  1   2 , Teruo Jojima  1 , Yusuke Kamiga  2 , Shintaro Sakurai  1 , Toshie Iijima  1 , Takuya Tomaru  1 , Ikuo Akutsu  2 , Teruo Inoue  2 , Isao Usui  1 , Yoshimasa Aso  1
Affiliations

Acute Effect of Imeglimin Add-on Therapy on 24-h Glucose Profile and Glycemic Variability in Patients with Type 2 Diabetes Receiving Metformin

Yasutake Shinohara et al. Med Princ Pract. 2024.

Abstract

Introduction: Imeglimin is a novel antidiabetic drug with insulinotropic and insulin-sensitizing effects that targets mitochondrial bioenergetics. We investigated acute effects of add-on therapy with imeglimin to preceding metformin on the 24-h glucose profile and glycemic variability assessed by continuous glucose monitoring (CGM) in patients with type 2 diabetes.

Methods: We studied 30 outpatients with type 2 diabetes inadequately controlled with metformin. CGM was used for 14 days straight during the research period. Imeglimin 2,000 mg/day was started on day 7 after initiating CGM. Several CGM parameters were compared between days 4-6 (prior to imeglimin treatment) and 11-13 (following the initiation of imeglimin treatment).

Results: After treatment with imeglimin, 24-h mean glucose was acutely decreased from 161.6 ± 48.0 mg/dL to 138.9 ± 32.2 mg/dL (p < 0.0001), while time in range (i.e., at a glucose level of 70-180 mg/dL) was significantly increased from 69.9 ± 23.9% to 80.6 ± 21.0% (p < 0.0001). Addition of imeglimin to metformin significantly decreased the standard deviation (SD) of 24-h glucose and mean amplitude of glycemic excursions, 2 indexes of glycemic variability. Baseline serum high-density lipoprotein (HDL) cholesterol was negatively correlated with changes in mean 24-h glucose (r = -0.3859, p = 0.0352) and those in SD (r = -0.4015, p = 0.0309).

Conclusions: Imeglimin add-on therapy to metformin acutely lowered 24-h glucose levels and improved glycemic variability in patients with type 2 diabetes on metformin. A higher serum HDL cholesterol at baseline was associated with a better response to acute effects of imeglimin on 24-h glucose levels and glycemic variability.

Keywords: Acute effect; Continuous glucose monitoring; Glycemic variability; Imeglimin; Metformin; Time in range.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Fig. 1.
Fig. 1.
Mean glucose levels evaluated by continuous glucose monitoring before and after treatment with imeglimin 2,000 mg/day in patients with type 2 diabetes receiving metformin.
Fig. 2.
Fig. 2.
Correlation between serum HDL cholesterol at baseline and changes in 24-h mean glucose (a) or changes in SD of 24-h glucose (b) after treatment with imeglimin.
See this image and copyright information in PMC

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