Effect of Imeglimin, a Novel Anti-Diabetic Agent, on Insulin Secretion and Glycemic Variability in Type 2 Diabetes Treated with DPP-4 Inhibitor: A 16-Week, Open Label, Pilot Study
Atsushi Itsukaichi,* Fukumi Yoshikawa,* Ayako Fuchigami, Yoko Iwata, Genki Sato, Masahiko Miyagi, Takahisa Hirose, Hiroshi Uchino Department of Diabetes, Metabolism and Endocrinology, Toho University Graduate School of Medicine, Tokyo, Japan*These authors contributed equally...
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Dove Medical Press
2025-01-01
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| author | Itsukaichi A Yoshikawa F Fuchigami A Iwata Y Sato G Miyagi M Hirose T Uchino H |
| author_facet | Itsukaichi A Yoshikawa F Fuchigami A Iwata Y Sato G Miyagi M Hirose T Uchino H |
| author_sort | Itsukaichi A |
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| description | Atsushi Itsukaichi,* Fukumi Yoshikawa,* Ayako Fuchigami, Yoko Iwata, Genki Sato, Masahiko Miyagi, Takahisa Hirose, Hiroshi Uchino Department of Diabetes, Metabolism and Endocrinology, Toho University Graduate School of Medicine, Tokyo, Japan*These authors contributed equally to this workCorrespondence: Hiroshi Uchino, Department of Diabetes, Metabolism, and Endocrinology, Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan, Tel +81-3-3762-4151, Fax +81-3-3765-6488, Email h.uchino@med.toho-u.ac.jpPurpose: Imeglimin is a novel oral antidiabetic agent that improves glucose tolerance. This study aimed to investigate the efficacy of combining imeglimin with dipeptidyl peptidase-4 inhibitor (DPP-4i), the most frequently prescribed first-line treatment for patients with type 2 diabetes (T2D) in Japan, to improve glycemic control.Patients and Methods: Eleven patients with T2D treated with DPP-4i alone (6.5% ≤ hemoglobin A1C [HbA1c] < 10%) received 1000 mg imeglimin twice daily for 16 weeks. A meal tolerance test (MTT) was conducted on seven of these patients to assess parameters associated with islet function or insulin tolerance, such as homeostasis model assessment (HOMA)-β-cell function (HOMA-β), HOMA-insulin resistance (HOMA-IR), C-peptide immunoreactivity (CPR) index, and glucagon kinetics. Continuous glucose monitoring was conducted to evaluate parameters for glycemic variability.Results: Sixteen weeks after imeglimin administration, the HbA1c level improved from 7.5%± 1.3% to 6.5%± 0.5% (p < 0.05), the casual blood glucose level significantly improved from 168.2± 55.4 to 127.8± 20.0 mg/dL (p=0.027), time in range increased from 65.0%± 0.34% to 90.0%± 0.08% (p < 0.05), and time above range reduced from 34.0%± 0.034% to 9.0%± 0.08% (p < 0.05). During MTT, we observed significantly reduced area under the curve (AUC)0– 180 glucose, increased AUC0-180 CPR/AUC0-180 glucose, CPR index, and HOMA-β (p< 0.05). HOMA-IR and glucagon kinetics did not change with the addition of imeglimin.Conclusion: The addition of imeglimin to DPP-4i significantly improved glycemic control and glycemic variability, based on increased glucose-induced insulin secretion, indicating its potential as a therapeutic option for patients with T2D.Keywords: imeglimin, DPP-4 inhibitor, time in range, glycemic variability, continuous glucose monitoring, meal tolerance test |
| format | Article |
| id | doaj-art-f1e1b865c82f4f7ebd4b2a23765f0d64 |
| institution | Kabale University |
| issn | 1178-7007 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Dove Medical Press |
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| series | Diabetes, Metabolic Syndrome and Obesity |
| spelling | doaj-art-f1e1b865c82f4f7ebd4b2a23765f0d642025-01-09T16:58:34ZengDove Medical PressDiabetes, Metabolic Syndrome and Obesity1178-70072025-01-01Volume 1810111199115Effect of Imeglimin, a Novel Anti-Diabetic Agent, on Insulin Secretion and Glycemic Variability in Type 2 Diabetes Treated with DPP-4 Inhibitor: A 16-Week, Open Label, Pilot StudyItsukaichi AYoshikawa FFuchigami AIwata YSato GMiyagi MHirose TUchino HAtsushi Itsukaichi,* Fukumi Yoshikawa,* Ayako Fuchigami, Yoko Iwata, Genki Sato, Masahiko Miyagi, Takahisa Hirose, Hiroshi Uchino Department of Diabetes, Metabolism and Endocrinology, Toho University Graduate School of Medicine, Tokyo, Japan*These authors contributed equally to this workCorrespondence: Hiroshi Uchino, Department of Diabetes, Metabolism, and Endocrinology, Toho University Graduate School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan, Tel +81-3-3762-4151, Fax +81-3-3765-6488, Email h.uchino@med.toho-u.ac.jpPurpose: Imeglimin is a novel oral antidiabetic agent that improves glucose tolerance. This study aimed to investigate the efficacy of combining imeglimin with dipeptidyl peptidase-4 inhibitor (DPP-4i), the most frequently prescribed first-line treatment for patients with type 2 diabetes (T2D) in Japan, to improve glycemic control.Patients and Methods: Eleven patients with T2D treated with DPP-4i alone (6.5% ≤ hemoglobin A1C [HbA1c] < 10%) received 1000 mg imeglimin twice daily for 16 weeks. A meal tolerance test (MTT) was conducted on seven of these patients to assess parameters associated with islet function or insulin tolerance, such as homeostasis model assessment (HOMA)-β-cell function (HOMA-β), HOMA-insulin resistance (HOMA-IR), C-peptide immunoreactivity (CPR) index, and glucagon kinetics. Continuous glucose monitoring was conducted to evaluate parameters for glycemic variability.Results: Sixteen weeks after imeglimin administration, the HbA1c level improved from 7.5%± 1.3% to 6.5%± 0.5% (p < 0.05), the casual blood glucose level significantly improved from 168.2± 55.4 to 127.8± 20.0 mg/dL (p=0.027), time in range increased from 65.0%± 0.34% to 90.0%± 0.08% (p < 0.05), and time above range reduced from 34.0%± 0.034% to 9.0%± 0.08% (p < 0.05). During MTT, we observed significantly reduced area under the curve (AUC)0– 180 glucose, increased AUC0-180 CPR/AUC0-180 glucose, CPR index, and HOMA-β (p< 0.05). HOMA-IR and glucagon kinetics did not change with the addition of imeglimin.Conclusion: The addition of imeglimin to DPP-4i significantly improved glycemic control and glycemic variability, based on increased glucose-induced insulin secretion, indicating its potential as a therapeutic option for patients with T2D.Keywords: imeglimin, DPP-4 inhibitor, time in range, glycemic variability, continuous glucose monitoring, meal tolerance testhttps://www.dovepress.com/effect-of-imeglimin-a-novel-anti-diabetic-agent-on-insulin-secretion-a-peer-reviewed-fulltext-article-DMSOimeglimindpp-4 inhibitortime in rangeglycemic variabilitycontinuous glucose monitoringmeal tolerance test |
| spellingShingle | Itsukaichi A Yoshikawa F Fuchigami A Iwata Y Sato G Miyagi M Hirose T Uchino H Effect of Imeglimin, a Novel Anti-Diabetic Agent, on Insulin Secretion and Glycemic Variability in Type 2 Diabetes Treated with DPP-4 Inhibitor: A 16-Week, Open Label, Pilot Study Diabetes, Metabolic Syndrome and Obesity imeglimin dpp-4 inhibitor time in range glycemic variability continuous glucose monitoring meal tolerance test |
| title | Effect of Imeglimin, a Novel Anti-Diabetic Agent, on Insulin Secretion and Glycemic Variability in Type 2 Diabetes Treated with DPP-4 Inhibitor: A 16-Week, Open Label, Pilot Study |
| title_full | Effect of Imeglimin, a Novel Anti-Diabetic Agent, on Insulin Secretion and Glycemic Variability in Type 2 Diabetes Treated with DPP-4 Inhibitor: A 16-Week, Open Label, Pilot Study |
| title_fullStr | Effect of Imeglimin, a Novel Anti-Diabetic Agent, on Insulin Secretion and Glycemic Variability in Type 2 Diabetes Treated with DPP-4 Inhibitor: A 16-Week, Open Label, Pilot Study |
| title_full_unstemmed | Effect of Imeglimin, a Novel Anti-Diabetic Agent, on Insulin Secretion and Glycemic Variability in Type 2 Diabetes Treated with DPP-4 Inhibitor: A 16-Week, Open Label, Pilot Study |
| title_short | Effect of Imeglimin, a Novel Anti-Diabetic Agent, on Insulin Secretion and Glycemic Variability in Type 2 Diabetes Treated with DPP-4 Inhibitor: A 16-Week, Open Label, Pilot Study |
| title_sort | effect of imeglimin a novel anti diabetic agent on insulin secretion and glycemic variability in type 2 diabetes treated with dpp 4 inhibitor a 16 week open label pilot study |
| topic | imeglimin dpp-4 inhibitor time in range glycemic variability continuous glucose monitoring meal tolerance test |
| url | https://www.dovepress.com/effect-of-imeglimin-a-novel-anti-diabetic-agent-on-insulin-secretion-a-peer-reviewed-fulltext-article-DMSO |
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