Different doses of imeglimin for management of type 2 diabetes mellitus: a systematic review, meta-analysis, and meta-regression of randomized clinical trials

ABSTRACT

Background

A new medication for type 2 diabetes mellitus (T2DM) called imeglimin can target all three organs involved in the pathogenesis of DM, namely the liver, skeletal muscles, and pancreas. This research seeks to examine the most efficacious and safe dose of imeglimin for the management of T2DM.

Research design and methods

Using particular keywords, we searched the CENTRAL, Medline, Scopus, and ClinicalTrials.gov databases for pertinent literature. The results of continuous variables were pooled into the mean difference (MD) and dichotomous variables into odds ratio (OR) along with their 95% confidence intervals (95% CI) using fixed-effect models.

Results

Our pooled analysis revealed that imeglimin 1000 mg twice daily [MD −0.90% p < 0.00001] and 1500 mg twice daily [MD −0.84% p = 0.0003] as monotherapy was associated with a higher reduction in the HbA_1c compared to placebo. This superiority was still maintained when given as combination therapy. Regrettably, there was an observed escalation in gastrointestinal AEs as the dosage of imeglimin was raised, despite the absence of a corresponding improvement in its efficacy in decreasing HbA_1c levels.

Conclusions

Our study suggests that imeglimin 1000 mg twice daily may offer the most optimum therapeutic effects for glycemic control without compromising its safety profiles.

KEYWORDS:

• Imeglimin
• diabetes
• management
• meta-analysis
• endocrinology

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contribution statement

HP: conceptualization, methodology, formal analysis, data curation, writing‐original draft, visualization, writing‐review, and editing. NNMS: conceptualization, methodology, formal analysis, data curation, writing‐original draft, visualization, writing‐review, and editing. TAY: conceptualization, methodology, formal analysis, data curation, writing‐original draft, writing‐review and editing. MT: conceptualization, methodology, formal analysis, data curation, writing‐original draft, writing‐review and editing. TIH: conceptualization, validation, supervision, writing‐review and editing. KS: conceptualization, validation, supervision, writing‐review and editing. All authors read and approved the final manuscript.

Supplementary Material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17446651.2023.2290488

Additional information

Funding

This work was not supported by any funding.