REVIEW ARTICLE Imeglimin: A Potential New Multi-Target Drug for Type 2 Diabetes

The Author(s) 2015. This article is published with open access at Springerlink.com Abstract Imeglimin is a novel agent currently in devel-opment to treat type 2 diabetes. Laboratory studies have demonstrated that it has the potential to impact the three main pathophysiologic components of type 2 diabetes: impaired glucose uptake by muscle tissue, excess hepatic gluconeogenesis, and increased beta-cell apoptosis. Pre-liminary human studies that have been published within the last 2 years demonstrate that imeglimin improves hemo-globin A1c and fasting plasma glucose similarly when compared with metformin and with sitagliptin. There has also been a low incidence of adverse effects, especially hypoglycemia, reported in these early human studies. Currently, imeglimin is lacking long-term evidence to demonstrate any effects on its cardiovascular safety, and data on morbidity and mortality, though some studies are currently in progress. There is great potential for imegli-min, if FDA approved, to play a significant role in the type 2 diabetes management algorithm. Key Points Imeglimin has been shown to have a positive impact on skeletal muscle glucose uptake, hepatic glucose production, and beta-cell apoptosis. Imeglimin has demonstrated similar clinical benefit in hemoglobin A1c and fasting plasma glucose when compared with metformin and sitagliptin. Although imeglimin has not yet achieved FDA approval, it is a promising new agent that could impact the treatment of type 2 diabetes.