{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:48:18Z","timestamp":1787014098730,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare the efficacy of adding imeglimin versus that of metformin dose escalation on glycemic control in subjects with type 2 diabetes treated with a dipeptidyl peptidase\u20104 inhibitor plus low\u2010dose metformin (500\u20131000\u2009mg\/day).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>In this multicentre, open\u2010labelled, prospective, randomized, parallel\u2010group comparison study, the addition of imeglimin (2000\u2009mg\/day) or metformin escalation was applied for 24\u2009weeks in eligible subjects. The primary endpoint was the mean change in glycated haemoglobin (HbA1c) over 24\u2009weeks. As the secondary endpoints, the occurrence of adverse events, changes in metabolic parameters, biomarkers and factors associated with HbA1c improvement were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010three eligible subjects were enrolled. Of them, 65 participants comprised the full analysis set. At 24\u2009weeks, the addition of imeglimin (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200933) resulted in greater improvement in HbA1c compared with metformin dose escalation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932) (from 7.61\u2009\u00b1\u20090.48% to 6.93\u2009\u00b1\u20090.49% in imeglimin and from 7.56\u2009\u00b1\u20090.61% to 7.09\u2009\u00b1\u20090.56% in metformin escalation; change difference: \u22120.21% [95% confidence interval: \u22120.41%, \u22120.01%] [\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038]); however, seven subjects in the imeglimin group discontinued imeglimin because of serious adverse events on gastrointestinal tract. In intra\u2010group pre\/post comparisons, imeglimin treatment significantly reduced body weight and improved liver enzyme elevation. There was a significant correlation between improvement levels of HbA1c and indicators of fatty liver disease in the imeglimin group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Imeglimin in combination with a dipeptidyl peptidase\u20104 inhibitor and low\u2010dose metformin improved HbA1c compared with metformin dose escalation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.16150","type":"journal-article","created":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T01:19:18Z","timestamp":1735262358000},"page":"1466-1476","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Efficacy of imeglimin treatment versus metformin dose escalation on glycemic control in subjects with type 2 diabetes treated with a dipeptidyl peptidase\u20104 inhibitor plus low\u2010dose metformin: A multicenter, prospective, randomized, open\u2010label, parallel\u2010group comparison study (\n                    <scp>MEGMI<\/scp>\n                    study)"],"prefix":"10.1111","volume":"27","author":[{"given":"Akihiro","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0713-221X","authenticated-orcid":false,"given":"Hiroshi","family":"Nomoto","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine Hokkaido University  Sapporo Japan"},{"name":"Division of Endocrinology, Metabolism, and Rheumatology, Department of Internal Medicine Asahikawa Medical University  Asahikawa 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