Hg 15.2 and Hematocrit 46. They have always been fine, despite falling iron markers.
Claude: “Your CGM mean over 37 days was 106 mg/dL. The ADAG regression converts that to an estimated A1c of 5.3%. Your measured A1c is 5.7%. That 0.4-point gap is exactly the magnitude iron deficiency produces.”
I may get a reticulocyte count to confirm.
Nothing necessarily to do with iron. Imeglimin itself causes longer persistence/lifespan of erythrocytes in serum, thus making A1c read higher - an artifact.
Imeglimin may affect hemoglobin A1c accuracy via prolongation of erythrocyte lifespan in patients with type 2 diabetes mellitus: insights from the INFINITY clinical trial
Imeglimin may be more effective or less effective than metformin depending on what the glucose handling defect is in a given individual, since the MOA differs between these two drugs. As far as I know @desertshores has taken both off label as his glucose handling is within norm - in that scenario apparently metformin has a stronger effect for him.
Iron deficiency does cause this as well and ferritin at 19 is clearly in deficient territory. (Hb being a bit high notwithstanding the shortage of iron may be high testosterone) Hence it could be both. The problem is that there are lots of inaccuracies in measuring these things. RBC turnover can be reduced by B9 deficiency as well. HbA1c can be increased merely by the sample metabolising between being taken and tested also some tests include the labile aldimine and others only the ketoamine moiety. However, labs don’t necessarily make this clear.
What was your metformin dose? If you were taking 1,000 mg of Imeglimin twice daily, that is comparable to taking 500 mg of metformin twice daily. At that dose equivalent I didn’t find that Imeglimin worked as well as metformin.
1000mg BID is not enough for the western population. I just posted about that here: Imeglimin: An Approved Diabetes Pill Just Made Old Mice Stronger - #14 by cl-user
Wouldn’t this cause elevated hemoglobin and hematocrit?
Ya, 1g Imeglimin 2x daily vs 1 gram Metformin once daily.
Across the dosing period,RBC count, hemoglobin, and hematocrit all drop.
This appears to be non-significant in either direction due to homeostatic mechanisms kicking in.
For me, after 11 years of trying everything to improve my blood glucose levels, Imeglimin was the first and only intervention that worked so far but it was masked by a glycation gap.
I just posted about this: Stubborn HbA1c? Beware the glycation gap!
Jagdish said due to tarriffs he can’t sell / help me. Alldaychemists.com stopped carrying imeglimin. Allday still carries a few SGLT2s. I have recently recieved things via Allday.
Anyone receive delivery of something from India recently (09162026).
tnx curt
Maulik has said he is shipping again, but I have not tried it.
Maulik has taken my order and payment and putting into boxes. My wife warns re an Oct 22 shut down of drugs entering USA from off shore pharmacies. I have no idea now impermeable this will be for Indian/Chinese drug sources…
There’s alot of political / back scratching / payoffs bitching one might waste time on re TrumpDrugs.com and the very marginally good deals offered up so far vs a huge just a HUGE loss for folks buying cancer drugs at fractions of list price from Canada etc.
TBD re how this sorts out. It could just be nothing given labor shortages, and the games the shippers play with what the contents are and value they put on the label… TBD
curt
I’ve got
One big question
IF metformin increases lifespan and its mechanism is different from simply lowering blood glucose, then DOES imeglimin has the same beneficial effect on lifespan besides BG lowering?
Maybe not. Maybe yes. And maybe even better, recalling mitochondrial beneficial effect.
Big IF.
Maybe its better then to take both simultaneously…
Metformin evidence for extending lifespan is flimsy at best.
I’m not qualified to even guess re taking both. I have decent glucose as shown via a CGM for several months. But its not good enough per the speakers on stage at the Metabolic confs (IMO). Inflammaging has one of several inputs of area under the curve of how much, how long insulin stays elevated. I risk drug side effects taking dapa (SGLT2, imeglimin 1000mg 2x and telimisartan 40mg to nudge blood pressure even lower plus telimisartan like imeglimin has a broader health positive foot print.
This is assuming that any side effect of these drugs don’t cause something else or negate theoretical healthspan extention benefits.
tnx curt
Metformin has shown life extending benefits only in combination with rapamycin (this effect has been shown in mice).
When just metformin was tested by itself (in mice), it did not extend lifespan.
Of course, there are no lifespan studies in humans, so we use animal models, but the idea is that if an intervention does not extend max lifespan in a mammalian model - and mice are very susceptible to life exrension effects in general - then it’s unlikely that it will suddenly work in humans. More often it goes in the other direction - an intervention shows healthspan benefits in an animal model, but has no such benefits in humans.
Keep in mind, normalizing lifespan by curing a disease or ameliorating it merely prevents life shortening, it is not max lifespan extension - if you have a deadly bacterial infection, the antibiotic will cure your infection, but will not extend your max lifespan, so the anitbiotic does not slow aging. There is some argument that metformin migh similarly benefit diabetic people allowing them to live longer (than those not on metfirmin), but again, that prevents, at best, life shortening, and is not max lifespan extension.
I’m not diabetic but have be hovering at the pre-diabetic line for at least 10 years with no appreciable change. I started taking 12.5 mg/day empagliflozin, primarily based on the growing body of gero- and reno- protective research. It hasn’t moved my BG markers much but I feel more energetic across the day. I’ve decided to add a relatively low dose of Imeglimin as an experiment. Empirical data on the combination is thin and good gero research is badly needed but the mechanistic data suggests that these two drugs could be a synergic combination for older males especially. The caveats are to ensure that it does not have outsize effects on BG, ketones, etc.
Is anyone working with this combination in a similar situation and for similar goals? I would appreciate hearing about your experiences to date.
@RobTuck For the same reasons I started 10mg Dapagflogzen(??) 1x and 1000mg Imeglimine AM and pre dinner, and tossed in a big health foot print blood pressure drug telmasartan (??) 40mg which ALSO aids glucose/insulin sensitivity. No down sides noticed. No lethargy like from metformin.
Pre the above drugs: Using a CGM, my carnivore diet still allowed my dawn effect to drift >110 ish, and hover 90-100 through the day. Post the above drugs; flat and below 90. Almost no dawn effect.
I’m stacking more chemicals… IGF-LR3 for muscle growth is said to lower glucose as well. TBD I need to put a Lingo CGM on asap to re-policeman my glucose, thus insulin. Last blood tests had my AM fasted insulin 3-4. Good.
Newer / newest last bit of fat loss chemicals the health/body builder/private health coaches are into: MVD-1/Sana, Bam-15, SLU-332-915, MA-5 (mitochonic acid 5)… A CGM is needed to make sure.
2 IU HGH to accelerate strained ribs along with a handfull of peptides; bpc, tb4, ghk-cu et al.
Take care, curt