Effect of metformin dose reduction versus continuation at imeglimin initiation on glycemic control in type 2 diabetes: a retrospective real-world analysis
Abstract
AIMS: To evaluate whether continuing versus reducing metformin at imeglimin initiation is associated with 24-week changes in HbA1c and body weight in routine practice, and to describe 48-week outcomes.
METHODS: Single-center retrospective study of adults with type 2 diabetes who started imeglimin 2000 mg/day (September 2022-August 2024). For the primary 24-week efficacy analysis, metformin users who tolerated and continued imeglimin through week 24 were classified as metformin continuation (no change) or metformin reduction (≥ 250 mg/day decrease, including discontinuation). The primary endpoint was 24-week ΔHbA1c. Associations were assessed with nonparametric tests and ANCOVA adjusting for age, sex, diabetes duration, and baseline HbA1c; sensitivity models additionally adjusted for baseline metformin dose and major concomitant glucose-lowering drug classes (SGLT2i, GLP-1RA, insulin, and sulfonylureas).
RESULTS: Seventy metformin users were included (continuation n = 34; reduction n = 36). At 24 weeks, HbA1c decreased by - 0.6% versus - 0.2% (median difference - 0.5%, 95% CI - 0.6 to - 0.3), and body weight by - 1.2 kg versus - 0.4 kg (median difference - 0.9 kg). The absolute metformin dose reduction correlated with ΔHbA1c (Spearman ρ = 0.52). Metformin continuation remained associated with greater adjusted HbA1c reduction in sensitivity ANCOVA (adjusted difference - 0.57%, 95% CI - 0.88 to - 0.26; P = 0.0006). In a 48-week cohort (n = 65) continuing imeglimin, metformin…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 65 participants or records.
Read the paper
Related studies
- Metformin as an adjuvant in breast cancer treatment
- Metformin Lysosomal Targeting: A Novel Aspect to Be Investigated for Metformin Repurposing in Neurodegenerative Diseases?
- Aberrant HSF1 signaling activation underlies metformin amelioration of myocardial infarction in mice
- Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines
- Protein Interaction Network for Identifying Vascular Response of Metformin (Oral Antidiabetic)
- Preventing Long COVID With Metformin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.