Real World Case Series Issue 6

Clinical Case Brief

50 Year Old Male

Bank Manager

Social History :

• Addicted to Tobacco and following sedentary Lifestyle

Family History :

• Father had T2DM

Physical Examination :

• BP: 130/80 mmHg
• Height: 165 cm
• Body Weight: 76 Kg

Laboratory Investigation before 20th Mar' 2024

• HbA1c: 9.9%
• FBG: 240 mg/dl
• PPG: 252 mg/dl

Medical History :

• T2DM from last 9 years

Medication History :

• Metformin Dose: 1000 mg BD
• Dapagliflozin Dose: 10 mg OD
• Sitagliptin Dose: 100 mg OD

Expert's Concern

• Patient with Uncontrolled Hyperglycemia especially HbAlc, fasting plasma and postprandial glucose level with Dyslipidemia and Obesity.
• On top of that patient is not willing to start insulin

Revised Treatment on 20th Mar' 2024 with Addition of Imeglimin: 1000 mg B.D.

Patient Complain

• Metformin not tolerated due to G.I. side effects

Post Follow up Changes in Medication :

• Imeglimin Dose: 1000 mg BD
• Dapagliflozin Dose: 10 mg OD
• Sitagliptin Dose: 100 mg OD

Key Findings after using Imeglimin for 3 months :

• HbA1c: 8.3%
• FBG: 208 mg/dl
• PPG: 220 mg/dl

Major Highlights of the Case :

• Avoided Metformin due to intolerance

Follow up Advice :

• Imeglimin 1000 ing BD to be continued for next 6 months

Experts' View :

1. The HbA1c is reduced from 9.9% to 8.3%
2. The Fasting Plasma Glucose at baseline 240 mg/dl is reduced to 208 mg/dl
3. Post prandial plasma glucose at baseline 252 mg/dl is reduced to 220 mg/dl

Benefits to patient :

• No Adverse effect
• No Hypoglycemia
• No U.T.1