When imeglimin is combined with metformin, the incidence rates of diarrhea and nausea reach as high as 15.6% and 10.9% respectively, which is significantly higher than with monotherapy or other combination regimens.
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From my perspective (an obsession with mitochondria and acetylation) it arguably would reduce ROS which reduces the creation of deletions in mtDNA, it also would improve ⟨ΔΨm⟩ which would improve gene expression. However, it would act as a prop rather than encouraging mitophagy (and particularly fission-mitophagy-fusion). Hence it looks like something worth taking with Rapamycin, but not something that would replace Rapamycin.
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Imeglimin, especially in combination with non-Metformin OHAs, improves glycemic control and reduces mitochondrial and inflammatory stress in T2DM patients. These findings support its use as an adjunctive therapy with broader metabolic benefits.
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