Abstract
Background: As an oral hypoglycaemic agent (OHA), imeglimin (Twymeeg) has been recently introduced to clinical practice for patients with type 2 diabetes mellitus (T2DM) as Twymeeg. It has beneficial pharmacological mechanisms, which are improving insulin secretion, increasing insulin sensitivity, and decreasing insulin resistance. Case Presentation: The case is 84-year-old man with mild cognitive impairment (MCI) for 3 years. He visited late August, 2021 our clinic for general malaise and was pointed out to have post-prandial blood glucose 336 mg/dL and HbA1c 8.6%. He was diagnosed with T2DM. Results: He was started to be given imeglimin 1000mg twice a day, and then HbA1c value was decreased to 7.3% in 4 weeks and 5.7% in 8 weeks. During 9-12 weeks, he felt loss of appetite and reduced food intake. Biochemical examination on 12 weeks showed decreased values of TP, Alb, HbA1c, glucose, free T3, and normal values of TSH, free T4. Doses of imeglimin were 500 mg twice a day for 9-12 weeks and discontinued after 12 weeks. Discussion: Regarding appetite loss, possible causes may include MCI, previous history of gallbladder dyskinesia, adverse effect of imeglimin, and so on. Further development of research will be expected for imeglimin in the future.
Highlights
Adequate treatment for type 2 diabetes mellitus (T2DM) has been discussed for long
The results showed moderate degree of diabetes with post-prandial blood glucose 336 mg/dL and HbA1c 8.6%
A new oral hypoglycaemic agent (OHA), imeglimin was administered to T2DM patient, which showed beneficial clinical effect
Summary
Adequate treatment for type 2 diabetes mellitus (T2DM) has been discussed for long. Professional practice committee of American Diabetes Association (ADA) has announced the guideline in Jan 2022 [1]. It has basically a small molecule similar to metformin, but it has a cyclic molecule containing a triazine ring [5]. For diabetic treatment, he and his family received nutrition therapy for adequate regular meal. He and his family received nutrition therapy for adequate regular meal His age has been rather higher, he was advised to have slight limited intake of carbohydrate amount per day. Case Presentation History & Physical: The patient is an 84-year-old male patient with Type 2 Diabetes Mellitus (T2DM). He was diagnosed to have mild cognitive impairment (MCI) about 3 years ago. Due to the biochemical exams on 12 weeks, Twymeeg was discontinued, and glucose variability has been followed up after that
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