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Medicine Matters diabetes

So here at the EASD I've been interested in hearing about some newer therapies for type 2 diabetes. Of course we've had a number of new therapies for type 2 diabetes over the last few years, including GLP-1 receptor agonists and SGLT2 inhibitors. But there is still an unmet need for new therapies that can make a difference to insulin resistance and also help stave off the inevitable decline in beta cell function that occurs as type 2 diabetes progresses.

So, I was really interested to hear about a completely novel approach with a drug called imeglimin. Imeglimin is a drug which works on mitochondrial bioenergetics and appears to have some very interesting effects in a lot of the tissues that are affected by type 2 diabetes. This includes improving insulin sensitivity in both liver and muscle and having the potential to preserve beta cell function, again, through its effects on the mitochondria.

Imeglimin has now been taken from preclinical studies that have shown these effects into clinical studies to look at its effects in people with type 2 diabetes. And a number of phase 2 and phase 3 studies were presented during the EASD [annual meeting]. These showed imeglimin is reasonably effective as an oral medication for the treatment of type 2 diabetes, reducing HbA1c from between about 0.6% and 1% on a background of metformin monotherapy.

In general, it seems to be quite a well-tolerated drug, although some people did report nausea and a few people did withdraw from the study because of this adverse effect. I think it's going to be very interesting to see how this new treatment develops over the next few years, and hopefully we will have an additional oral therapy to add to the armamentarium of treatments for type 2 diabetes within the next few years.