2868-LB: Durable Glycemic Control and Improved Patient-Reported Outcomes with Imeglimin: Eighteen-Month Real-World Evidence from India

Introduction and Objective: Imeglimin improves mitochondrial bioenergetics and has shown glycemic efficacy in randomized trials. However, long-term real-world data evaluating both metabolic durability and patient-reported outcomes remain limited. Methods: This prospective real-world cohort study included adults with type 2 diabetes initiating imeglimin therapy in routine clinical practice. Patients were followed for up to 18 months. Glycemic outcomes and patient-reported quality-of-life measures were evaluated. Diabetes distress was assessed using the validated Problem Areas in Diabetes (PAID) scale. Interim analysis was conducted in the first 100 patients completing the 18-month follow-up. Results: Seventy-four percent of patients continued imeglimin therapy through 18 months, demonstrating good long-term tolerability. HbA1c decreased from 7.90% at 6 months to 7.32% at 18 months (mean change −0.58%, p<0.001), indicating sustained glycemic control. Significant improvements were observed in patient-reported outcomes, including reduction in diabetes distress (PAID −17.9 points, p<0.001), improved physical functioning (+11.7), mental health (+14.8), and work productivity (+12.5). Symptom burden (−21.0) and fear of hypoglycemia (−10.0) also declined. Patients discontinuing therapy demonstrated a non-significant increase in HbA1c (+0.55%, p=0.08). Conclusion: Improvement in diabetes distress suggests imeglimin may influence patient engagement and treatment satisfaction beyond glycemic control.Imeglimin therapy demonstrated durable glycemic benefit over 18 months in routine clinical practice while significantly improving multiple patient-reported quality-of-life domains. These findings support the role of imeglimin as a therapy addressing both metabolic control and patient-centered outcomes in type 2 diabetes management. Disclosure B. Saboo: None. S. Patil: None. H. Hirani: None. A. Modi: None. A. Maheshwari: None.