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

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 asses...

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Published inMedical principles and practice Vol. 33; no. 6; pp. 569 - 577
Main Authors Shinohara, Yasutake, Jojima, Teruo, Kamiga, Yusuke, Sakurai, Shintaro, Iijima, Toshie, Tomaru, Takuya, Akutsu, Ikuo, Inoue, Teruo, Usui, Isao, Aso, Yoshimasa
Format Journal Article
LanguageEnglish
Published Basel, Switzerland S. Karger AG 01.12.2024
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ISSN1011-7571
1423-0151
1423-0151
DOI10.1159/000540852

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Abstract 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.
AbstractList 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.
Continuous glucose monitoring (CGM) can provide information on 24-h mean blood glucose level, time in the glucose target range (TIR), and indices of glycemic variability. [...]the present study used (CGM) to investigate the acute effect of imeglimin add-on therapy on 24-h glucose levels and glycemic variability in patients with type 2 diabetes receiving metformin. Demographic, clinical, and laboratory data for patients with type 2 diabetes receiving metformin at baseline Variables N (M/F) 30 (23/7) Age, years 60.5±13.6 Body weight, kg 69.7±12.6 BMI, kg/m2 25.0±3.5 Diabetes duration, years 7.5 (2, 13.5) FPG, mg/dL 170.3±84.4 HbA1c, % 8.1±1.3 Fasting C peptide, ng/dL 2.93 (2.03, 3.65) LDL-C, mg/dL 96.5±27.9 HDL-C, mg/dL 58.3±24.1 Triglyceride, mg/dL 127 (94.5, 144) eGFR, mL/min/1.73 m2 78.5±19.4 CGM data  24-h mean glucose, mg/dL 161.6±48.0  Mean postprandial glucose   Breakfast, mg/dL 145.6±51.4   Lunch, mg/dL 158.0±70.2   Dinner, mg/dL 161.1±73.6  GMI, % 7.2±1.2  SD of 24-h glucose, mg/dL 41.6±13.6  CV, % 25.8±5.8  MAGE, mg/dL 103.3±34.7  TIR, % 69.9±23.4  TBR, % 0 (0, 0)  TAR, % 24.0 (10.5, 40.0) Antidiabetic drugs  Metformin use, n (%) 30 (100)   Mean dose, mg 992  SU use, n (%) 10 (33.3)  α-GI use, n (%) 1 (3.33)  Insulin use, n (%) 13 (43.3)  DPP-4 inhibitors, n (%) 15 (20.0)  GLP-1RA, n (%) 16 (53.3)  SGLT2 inhibitors, n (%) 21 (70.0)  Pioglitazone, n (%) 1 (3.33) Data are the mean ± SD, number (percentage) or the median and interquartile ranges. BMI, body mass index; FPG, fasting plasma glucose; Hb, hemoglobin; LDL, low-density lipoprotein; HDL, high-density lipoprotein; eGFR, estimated glomerular filtration; CGM, continuous glucose monitoring; GMI, glucose monitoring index; SD, standard deviation; CV, coefficient of variation; MAGE, mean amplitude of glycemic excursions; TIR, time in range; TBR, time below range; TAR, time above range; SU, sulfonylurea; α-GI, alfa-glucosidase inhibitors; DPP, dipeptidyl peptidase; GLP-1RA, glucagon-like peptide-1 receptor agonists; SGLT2, sodium-glucose co-transporter 2. GMI, glucose monitoring index; SD, standard deviation; CV, coefficient of variation; MAGE, mean amplitude of glycemic excursions; MPPGE, mean of postprandial glucose excursion; TIR, time in range; TBR, time below range; TAR, time above range.
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.
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.INTRODUCTIONImeglimin 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.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).METHODSWe 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).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).RESULTSAfter 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).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.CONCLUSIONSImeglimin 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.
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. 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). 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). 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.
Author Sakurai, Shintaro
Tomaru, Takuya
Inoue, Teruo
Aso, Yoshimasa
Kamiga, Yusuke
Akutsu, Ikuo
Shinohara, Yasutake
Jojima, Teruo
Iijima, Toshie
Usui, Isao
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  email: *Yoshimasa Aso, yaso@dokkyomed.ac.jp
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Issue 6
Keywords Imeglimin
Continuous glucose monitoring
Metformin
Glycemic variability
Acute effect
Time in range
Language English
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Snippet Abstract Introduction: Imeglimin is a novel antidiabetic drug with insulinotropic and insulin-sensitizing effects that targets mitochondrial bioenergetics. We...
Introduction: Imeglimin is a novel antidiabetic drug with insulinotropic and insulin-sensitizing effects that targets mitochondrial bioenergetics. We...
Imeglimin is a novel antidiabetic drug with insulinotropic and insulin-sensitizing effects that targets mitochondrial bioenergetics. We investigated acute...
Continuous glucose monitoring (CGM) can provide information on 24-h mean blood glucose level, time in the glucose target range (TIR), and indices of glycemic...
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SubjectTerms Acidosis
Adult
Aged
Antidiabetics
Blood Glucose - analysis
Blood Glucose - drug effects
Body mass index
Diabetes
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - drug therapy
Drug dosages
Drug Therapy, Combination
Female
Glucose monitoring
Glycated Hemoglobin - analysis
Glycated Hemoglobin - drug effects
Hemoglobin
High density lipoprotein
Humans
Hypoglycemic Agents - pharmacology
Hypoglycemic Agents - therapeutic use
Insulin
Lipoproteins
Male
Metformin - therapeutic use
Middle Aged
Original Paper
Peptides
Triazines - administration & dosage
Triazines - therapeutic use
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Title Acute Effect of Imeglimin Add-on Therapy on 24-h Glucose Profile and Glycemic Variability in Patients with Type 2 Diabetes Receiving Metformin
URI https://karger.com/doi/10.1159/000540852
https://www.ncbi.nlm.nih.gov/pubmed/39134001
https://www.proquest.com/docview/3143266367
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https://pubmed.ncbi.nlm.nih.gov/PMC11631041
Volume 33
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