This article will introduce and review a new potential pharmacologic agent, imeglimin, comparing its
basic and clinical activity to that of other widely used medications.In general, pharmacologic therapy includes not only initial antihyperglycemic agents, but also more intensive approaches to glycemic control over time, often requiring multiple medications with synergistic mechanisms of action [4]. At first glance it seems that there are sufficient numbers of therapeutic classes of agents to treat T2DM,with each class varying in mechanism, safety, efficacy and route of administration; however, few drugs target all three of the main defects associated with T2DM, which is why complex medication regimens are often required to achieve glycemic control. Metformin is widely recognized as first- line therapy in multiple treatment algorithms, and is known to work primarily by limiting hepatic glucose production, one of the key defects of T2DM
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