A Brief Overview of Imeglimin Hydrochloride

Imeglimin hydrochloride is the first oral antidiabetic agent from the new glimin class that was first approved in Japan in 2021 and subsequently introduced in India in 2022. It is a derivative of tetrahydrotriazine made from metformin and tetrahydrotriazine precursors and primarily focuses on improving mitochondrial function. Unlike other types of diabetic treatments, imeglimin works through multiple mechanisms; it improves insulin sensitivity and decreases hepatic glucose production, as well as stimulates pancreatic beta cells, increases mitochondrial activity and decreases oxidative damage. All of these actions combine to combat the main causes of type 2 diabetes; namely, insulin resistance, overproduction of glucose and dysfunction of beta cells. Pharmacokinetics show moderate oral absorption with very low levels of protein binding in plasma, no evidence of cytochrome P450 interactions and mostly elimination of the parent compound through the kidneys. Imeglimin demonstrates promise as a therapeutic candidate that is well tolerated and has a distinct mechanism of action for the complete treatment of type 2 diabetes mellitus.