RESUMO
OBJECTIVE: Imeglimin is a novel anti-diabetic 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-hour 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 2000 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, mean 24-hour glucose acutely decreased from 161.6ï±48.0 mg/dl to 138.9ï±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 69.9ï± 23.9% to 80.6ï± 21.0% (p < 0.0001). Addition of imegliimin to metformin significantly decreased the standard deviation (SD) of 24-hour glucose and mean amplitude of glycemic excursions, 2 indexes of glycemic variability. Baseline serum HDL cholesterol was negatively correlated with changes in mean 24-hour 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-hour 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-hour glucose levels and glycemic variability.