1789-P: Age and the Efficacy of Imeglimin in Type 2 Diabetes: A Three-Month, Real-World Study in Japanese Patients

Introduction and Objective: Imeglimin is a novel antidiabetic agent that enhances mitochondrial function, promoting insulin secretion and improving glucose metabolism in liver and skeletal muscle. Despite its clinical use in Japan, real-world evidence on its efficacy across ages and its broader metabolic effects in type 2 diabetes mellitus (T2DM) remains limited. We evaluated the efficacy and safety of imeglimin and assessed whether patient age influences treatment effects. Methods: Fifty-two Japanese outpatients with T2DM received imeglimin 1,000 mg twice daily for three months. Pre- and post-treatment assessments included HbA1c, body weight, BMI, lipid profile, hepatic enzymes, renal markers, uric acid, and amylase. Results: Imeglimin significantly reduced body weight, BMI, and HbA1c from baseline. Lipid parameters improved, with decreases in total cholesterol, LDL-cholesterol, and non-HDL-cholesterol, along with a more favorable atherogenic profile. Hepatic enzymes (AST, ALT, γ-GTP) declined, indicating improvement in liver-related parameters. Renal indices (BUN, creatinine, eGFR) and amylase showed no clinically relevant changes, supporting a favorable safety profile; uric acid showed no overall change. The magnitude of reductions in hepatic enzymes and uric acid varied with age and baseline values, whereas the primary glycemic outcome (HbA1c reduction) was not influenced by age, suggesting consistent glycemic benefits across a wide range of age. Conclusion: Three months of imeglimin therapy improved glycemic control and favorably modified weight, lipid profile, and hepatic enzymes in Japanese patients with T2DM, without adverse effect in the kidney. HbA1c reduction was age-independent, indicating that imeglimin provides reliable glycemic improvement from younger to older adults and may be particularly useful when lifestyle interventions are difficult to implement. These findings support imeglimin as a safe, effective option for comprehensive metabolic management in routine care. Disclosure M. Kusunoki: None. F. Hisano: None. S. Matsuda: None. T. Miyata: None.