Effect of Imeglimin on mitochondrial function in patients with type 2 diabetes mellitus: a prospective cohort study

BackgroundImeglimin, a novel oral hypoglycemic agent, is known to influence mitochondrial function and glucose metabolism. This study evaluates its effects on glycemic control, mitochondrial DNA (mtDNA) copy number, and telomere dynamics in type 2 diabetes mellitus (T2DM).MethodsType 2 diabetes mell...

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Main Authors: Abhishek Satheesan, Janardanan Kumar, Kakithakara Vajravelu Leela, Ria Murugesan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1585834/full
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author Abhishek Satheesan
Janardanan Kumar
Kakithakara Vajravelu Leela
Ria Murugesan
author_facet Abhishek Satheesan
Janardanan Kumar
Kakithakara Vajravelu Leela
Ria Murugesan
author_sort Abhishek Satheesan
collection DOAJ
description BackgroundImeglimin, a novel oral hypoglycemic agent, is known to influence mitochondrial function and glucose metabolism. This study evaluates its effects on glycemic control, mitochondrial DNA (mtDNA) copy number, and telomere dynamics in type 2 diabetes mellitus (T2DM).MethodsType 2 diabetes mellitus patients were assigned to one of four treatment groups: (1) Imeglimin alone, (2) Imeglimin with metformin, (3) Imeglimin with other oral hypoglycemic agents, and (4) Metformin with other oral hypoglycemic agents. Clinical and metabolic parameters, mtDNA copy number, and relative telomere length were assessed at baseline and six months. Statistical analyses included paired t-tests and mixed models.ResultsThe study included participants with a mean age of 55.6 years (57% male, BMI 28.8 kg/m2). HbA1c significantly decreased in the Imeglimin + Other OHA (p < 0.001), Imeglimin + Metformin (p < 0.001), and Metformin + Other OHA (p < 0.001) groups, with a smaller but significant decrease in the Imeglimin monotherapy group (p = 0.04). mtDNA copy number increased significantly in the Imeglimin-based combination groups (p < 0.05) but not with monotherapy (p = 0.18). No serious adverse events were reported. Relative telomere length was only associated with age and changes in LDL-c levels.ConclusionImeglimin-based combination therapy effectively improves glycemic control and mitochondrial function, while monotherapy offers limited benefits. Combination therapy may be preferable for optimizing metabolic outcomes in T2DM. No significant change in telomere length was observed during the short period of time.
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spelling doaj-art-9ac20919edb74773ac7f0e22da644a3f2025-08-20T03:58:18ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-08-011610.3389/fendo.2025.15858341585834Effect of Imeglimin on mitochondrial function in patients with type 2 diabetes mellitus: a prospective cohort studyAbhishek Satheesan0Janardanan Kumar1Kakithakara Vajravelu Leela2Ria Murugesan3Department of Microbiology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Chengalpattu, Tamil Nadu, IndiaDepartment of General Medicine, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Chengalpattu, Tamil Nadu, IndiaDepartment of Microbiology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Chengalpattu, Tamil Nadu, IndiaDepartment of Microbiology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Chengalpattu, Tamil Nadu, IndiaBackgroundImeglimin, a novel oral hypoglycemic agent, is known to influence mitochondrial function and glucose metabolism. This study evaluates its effects on glycemic control, mitochondrial DNA (mtDNA) copy number, and telomere dynamics in type 2 diabetes mellitus (T2DM).MethodsType 2 diabetes mellitus patients were assigned to one of four treatment groups: (1) Imeglimin alone, (2) Imeglimin with metformin, (3) Imeglimin with other oral hypoglycemic agents, and (4) Metformin with other oral hypoglycemic agents. Clinical and metabolic parameters, mtDNA copy number, and relative telomere length were assessed at baseline and six months. Statistical analyses included paired t-tests and mixed models.ResultsThe study included participants with a mean age of 55.6 years (57% male, BMI 28.8 kg/m2). HbA1c significantly decreased in the Imeglimin + Other OHA (p < 0.001), Imeglimin + Metformin (p < 0.001), and Metformin + Other OHA (p < 0.001) groups, with a smaller but significant decrease in the Imeglimin monotherapy group (p = 0.04). mtDNA copy number increased significantly in the Imeglimin-based combination groups (p < 0.05) but not with monotherapy (p = 0.18). No serious adverse events were reported. Relative telomere length was only associated with age and changes in LDL-c levels.ConclusionImeglimin-based combination therapy effectively improves glycemic control and mitochondrial function, while monotherapy offers limited benefits. Combination therapy may be preferable for optimizing metabolic outcomes in T2DM. No significant change in telomere length was observed during the short period of time.https://www.frontiersin.org/articles/10.3389/fendo.2025.1585834/fullImegliminmitochondrial DNAtelomere lengthtype 2 diabetesglycemic control
spellingShingle Abhishek Satheesan
Janardanan Kumar
Kakithakara Vajravelu Leela
Ria Murugesan
Effect of Imeglimin on mitochondrial function in patients with type 2 diabetes mellitus: a prospective cohort study
Frontiers in Endocrinology
Imeglimin
mitochondrial DNA
telomere length
type 2 diabetes
glycemic control
title Effect of Imeglimin on mitochondrial function in patients with type 2 diabetes mellitus: a prospective cohort study
title_full Effect of Imeglimin on mitochondrial function in patients with type 2 diabetes mellitus: a prospective cohort study
title_fullStr Effect of Imeglimin on mitochondrial function in patients with type 2 diabetes mellitus: a prospective cohort study
title_full_unstemmed Effect of Imeglimin on mitochondrial function in patients with type 2 diabetes mellitus: a prospective cohort study
title_short Effect of Imeglimin on mitochondrial function in patients with type 2 diabetes mellitus: a prospective cohort study
title_sort effect of imeglimin on mitochondrial function in patients with type 2 diabetes mellitus a prospective cohort study
topic Imeglimin
mitochondrial DNA
telomere length
type 2 diabetes
glycemic control
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1585834/full
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