A Diabetic Male with Arteriosclerosis and Pericardial Cyst Treated by Imeglimin

The patient is a 70-year-old male who developed back pain in May 2021. He was diagnosed with a ureteral stone and type 2 diabetes (T2D) with an HbA1c of 9.3% in 2021. After a successful operation, he continued treatment for T2D. Pulse wave velocity (PWV) showed an ankle-brachial index (ABI) of 0.78/0.83 (R/L) and a cardio-ankle vascular index (CAVI) of 12.9/13.9, suggesting arteriosclerosis and peripheral artery disease (PAD). Computed tomography (CT) showed a movable lesion adjacent to the right heart, suggesting a pericardial cyst. HbA1c had been stable after that but increased during the summer of 2024; he then started imeglimin (Twymeeg), which was associated with clinical efficacy and without gastrointestinal adverse effects (GI-AE).