From the Research
Imeglimin is a novel oral antidiabetic medication that represents the first in a new class called glimins, working through a unique mechanism of action by targeting mitochondrial function to improve glucose metabolism, as described in the study by 1. The mechanism of action of imeglimin involves dual effects:
- Amplification of glucose-stimulated insulin secretion (GSIS) and preservation of β-cell mass
- Enhanced insulin action, including the potential for inhibition of hepatic glucose output and improvement in insulin signalling in both liver and skeletal muscle. At a cellular and molecular level, imeglimin's underlying mechanism may involve correction of mitochondrial dysfunction, a common underlying element of type 2 diabetes pathogenesis, as noted in the study by 1. Imeglimin is primarily used for the treatment of type 2 diabetes mellitus, either as monotherapy or in combination with other antidiabetic medications. Some key points about imeglimin include:
- The typical dosage is 1000 mg twice daily with meals
- Clinical studies have shown that imeglimin effectively reduces HbA1c levels by approximately 0.5-0.9% compared to placebo, with minimal risk of hypoglycemia and a neutral effect on body weight, as seen in the study by 2
- It also demonstrates good gastrointestinal tolerability compared to some other diabetes medications
- Imeglimin may be particularly beneficial for patients who cannot tolerate or have contraindications to other antidiabetic medications, especially those with renal impairment since it has shown efficacy and safety in this population, as mentioned in the study by 1. The medication was first approved in Japan (under the brand name Twymeeg) in 2021, though availability varies by country as regulatory approvals continue worldwide, as noted in the example answer. In comparison to other antidiabetic medications, such as GLP-1 receptor agonists, imeglimin has a unique mechanism of action and may offer benefits for certain patients, as discussed in the study by 3. However, the choice of medication should be individualized based on patient characteristics, medical history, and other factors, as emphasized in the study by 4. Overall, imeglimin is a valuable addition to the treatment options for type 2 diabetes, offering a new mechanism of action and potential benefits for patients who cannot tolerate or have contraindications to other medications, as described in the study by 1.