Imeglimin

Abstract

Glycemic control for type 2 diabetes continues to be a global concern, with diabetes entering the top 10 causes of death globally, at number nine, in 2020 (1). Studies have found that glycemic control has declined in the last several years, with <60% of patients meeting their A1C goal in 2014 (2). A more recent review found that young adults with type 2 diabetes have worse glycemic control than past cohorts, with an average A1C of 8.5% (3). There are many challenges to the management of diabetes, including high health care costs, poor patient adherence, and contraindications to and side effect profiles of available drug classes that limit their use.Imeglimin is a novel antidiabetic agent for the treatment of type 2 diabetes. It is the first in a new tetrahydrotriazine-containing class of oral antidiabetic agents referred to as glimins (4). Imeglimin works by multiple mechanisms of action and has been shown to increase insulin secretion, reverse pancreatic b-cell dysfunction, and prevent death of human epithelial cells, suggesting the potential for end-organ protection.Although not yet approved by the U.S. Food and Drug Administration (FDA), imeglimin may provide a valuable new treatment option in the future.

Clinical Efficacy of Imeglimin (Twymeeg) for Elderly Patient with Type 2 Diabetes Mellitus (T2DM)

“…What is the fundamental characteristic mechanism for imeglimin? It has been the first medicine for tetrahydrotriazine-containing class agent as glimins [9]. It may work by multiple pathway mechanism such as increasing insulin secretion, improving beta-cell function and preventing epithelial cell death [10]).…”

What Role do Mitochondria Have in Diastolic Dysfunction? Implications for Diabetic Cardiomyopathy and Heart Failure With Preserved Ejection Function

“…Although described as an oxidative phosphorylation blocker that targets complex I, imeglimin improves function of the electron transport chain, reduces mitochondrial ROS, and modulates ER homeostasis. [78][79][80] In addition, imeglimin increases insulin secretion and protects pancreatic b-cells. In the two-hit mouse model, imeglimin suppressed the upregulation of iNOS and restored expression of Xbp1s.…”

Elderly Female of Type 2 Diabetes (T2D) and Dementia with Clinical Improvement by Imeglimin (Twymeeg)

“…Furthermore, the latest novel OHA is imeglimin (Twemeeg) that shows dual efficacy of increasing insulin secretion and decreasing insulin resistance [5,6]. The characteristic point of imeglimin includes the similarity of molecules with metformin [7]. It has been the first-line OHA for a long time, used worldwide [8].…”