What is Imeglimin (Twymeeg)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 13, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Research

Imeglimin is a recommended treatment option for type 2 diabetes, particularly for patients who are inadequately controlled with metformin monotherapy or require combination therapy with other antidiabetic agents, due to its favorable safety profile and efficacy in improving glycemic control, as demonstrated in the most recent and highest quality study 1.

Key Points

  • Imeglimin is a novel oral antidiabetic medication that represents the first in a new class called glimins, with a unique mechanism of action that targets the three main pathophysiologic components of type 2 diabetes: impaired glucose uptake by muscle tissue, excess hepatic gluconeogenesis, and increased β-cell apoptosis.
  • The recommended dose of imeglimin is 1000 mg twice daily with meals for adults with type 2 diabetes, which can be used as monotherapy or in combination with other antidiabetic medications.
  • Imeglimin has been shown to have a favorable safety profile with low risk of hypoglycemia and minimal gastrointestinal side effects compared to some other diabetes medications, as demonstrated in a 52-week, open-label, multicentre phase 3 trial 1.
  • The most recent and highest quality study 1 demonstrated that imeglimin provides well-tolerated, long-term safety and efficacy in both monotherapy and oral combination therapy in Japanese patients with type 2 diabetes, with a significant reduction in HbA1c levels and fasting plasma glucose.

Benefits and Risks

  • Benefits: imeglimin has been shown to improve glycemic control, reduce insulin resistance, and increase insulin secretion, with a favorable safety profile and low risk of hypoglycemia.
  • Risks: common side effects may include mild gastrointestinal disturbances, and the medication should be used with caution in those with severe renal impairment.

Clinical Use

  • Imeglimin can be used as monotherapy or in combination with other antidiabetic medications, such as metformin, α-glucosidase inhibitors, biguanides, dipeptidyl peptidase-4 inhibitors, glinides, glucagon-like peptide-1 receptor agonists, sodium-glucose co-transporter-2 inhibitors, sulphonylureas, or thiazolidinediones.
  • Patients should be aware of the potential side effects and monitoring requirements, and the medication should be used under the guidance of a healthcare professional.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.