Last updated September 12, 2026
Key finding
HbA1c decreased by 0.55% at week 104 (p < 0.001 vs. baseline).
This study evaluated the long-term efficacy and safety of imeglimin in Japanese patients with type 2 diabetes when added to DPP-4 inhibitors, showing significant improvements in HbA1c levels.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Long-Term (1–5 y)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study evaluated the long-term efficacy and safety of imeglimin in Japanese patients with type 2 diabetes when added to DPP-4 inhibitors, showing significant improvements in HbA1c levels.
This research highlights the potential of imeglimin as a valuable addition to diabetes management regimens, particularly for patients who are already on DPP-4 inhibitors. The significant reduction in HbA1c and the absence of hypoglycemic events suggest that imeglimin could enhance patient outcomes and safety in long-term diabetes care.
The study included only Japanese patients, limiting generalizability. Long-term effects beyond 2 years were not assessed. The sample size and demographic diversity were not specified.
Published in
Publication details and source links for this paper.
Masashi S, Takeshi O, Masahiro I, Hideaki K, Kohei K. Long-term efficacy and safety of imeglimin added to DPP-4 inhibitors in Japanese patients with type 2 diabetes. Diabetes, Obesity & Metabolism. 2026;28(10):9101-9111. doi:10.1111/dom.71079
HbA1c decreased by 0.55% at week 104 (p < 0.001 vs. baseline).
Sustained improvements in glucose area under the curve were observed.
Improvements in insulin sensitivity were sustained over time.
No hypoglycemic events were reported in elderly patients over 2 years.
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Imeglimin and Glucose area under the curve (AUC), HbA1c, Insulin sensitivity, and 1 more.
This study contributes evidence to
Primary intervention
Imeglimin
Primary outcomes
Evidence topics
Primary intervention
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
3
Related topics
4
Evidence pairs
1264
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Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence topic
matched_outcome
Related evidence
Evidence topic
Save evidence
Core evidence
The primary outcomes reported in this study.
Imeglimin → Glucose area under the curve (AUC)
Imeglimin → Glucose area under the curve (AUC)
Imeglimin → Severe Hypoglycemic Events
Imeglimin → Severe Hypoglycemic Events
Evidence Library
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Imeglimin and HbA1c, Imeglimin and Postprandial and OGTT Glucose.
This study contributes to the evidence on the following intervention-outcome relationships.
Medications
Medications
Curated evidence collections and hubs this study is part of.
All studies measuring HbA1c
Measures HbA1c as a key outcome.
All studies on Imeglimin
Contributes to Imeglimin evidence base.
All studies measuring Postprandial and OGTT Glucose
Measures Postprandial and OGTT Glucose as a key outcome.
Latest published studies
Published within the last 2 years.
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4 results
1 results
4 results
4 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Imeglimin appears to lower HbA1c.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
HbA1c
EvidenceScore™ Strong | EvidenceScore™ 79.0 | strong positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Imeglimin for glucose area under the curve (AUC).
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Glucose area under the curve (AUC)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Imeglimin for insulin sensitivity.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Insulin sensitivity
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear effect of Imeglimin on severe hypoglycemic events.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Severe Hypoglycemic Events
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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