Imeglimin lowers CVD risk by improving postprandial flow-mediated dilation among diabetes patients

Cardiovascular disease (CVD) is the major cause of mortality in type 2 diabetes and high blood sugar, dyslipidemia, and hypertension are risk factors that contribute significantly to atherosclerosis.

A recent research published in Diabetes Therapy suggests that imeglimin treatment improved flow-mediated dilation (FMD) two hours after eating. Further Imeglimin may have improved postprandial FMD by lowering postprandial blood sugar and impacting factors unrelated to  blood sugar control. These effects may have a favorable impact on CVD in patients with type 2 diabetes.

Diabetes patients are at risk for endothelial dysfunction, which can lead to cardiovascular disease. Because this dysfunction may be a first, reversible stage in the development of atherosclerosis and cardiovascular disease, early diagnosis of endothelial dysfunction is essential for its prevention. Imeglimin is a brand-new anti-diabetic medication that increases insulin sensitivity and glucose-stimulated insulin secretion (GSIS). Imeglimin being a new emerging oral hypoglycemic medication therefore, Uchida and colleagues investigation this under the assumption of endothelial function enhancement.

Imeglimin was given to participants in this trial who had type 2 diabetes and a HbA1c of less than 6.5% but were not taking insulin treatment. Before and three months after injection, a meal tolerance test (592 kcal, 75.0 g of glucose, and 28.5 g of fat) was conducted, and blood sugar, glucagon, endothelium function insulin, and triglycerides were measured. Flow-mediated dilation was used to evaluate endothelial function.

The key findings of this study were:

Twelve patients, with a median age of 55.5 years (having interquartile range [IQR] of 51.3-66.0) and a gender ratio of 50% male, were enrolled. 

Although there were no differences in fasting FMD before or 3 months after imeglimin treatment, 2 h postprandial FMD had dramatically improved. Imeglimin treatment improved significantly HbA1c, fasting glucose, and 2 h postprandial glucose in terms of the glucose profile. 

In a univariate correlation coefficient analysis, the difference in 2 h postprandial FMD between before and 3 months after imeglimin treatment (2 h postprandial FMD) was inversely linked with 2 h postprandial glucose. 

Three months after taking imeglimin, patients' postprandial FMD had improved in both patients with and without lowered postprandial glucose.

Reference: 

Uchida, T., Ueno, H., Konagata, A., Taniguchi, N., Kogo, F., Nagatomo, Y., Shimizu, K., Yamaguchi, H., & Shimoda, K. (2023). Improving the Effects of Imeglimin on Endothelial Function: A Prospective, Single-Center, Observational Study. In Diabetes Therapy. Springer Science and Business Media LLC. https://doi.org/10.1007/s13300-023-01370-z