Table 1.

Possible molecular mechanisms by which imeglimin improves glucose homeostasis.

Mechanisms	Effects	Ref.
Insulin sensitivity	Increases insulin sensitivity and reduces insulin resistance via different molecular pathways such as promoting Akt phosphorylation	[9, 18]
Gluconeogenesis	Modulates genes involved in hepatic gluconeogenesis as PEPCK and G6Pase, declined gluconeogenesis	[12, 19, 23]
β-Cells' function and insulin secretion	Protects against beta-cell death, increases beta cell mass, and improves glucose-induced insulin release from islets	[9, 11, 24–26]
Mitochondrial function	Improves mitochondrial function in beta cells as well as other tissues	[13, 18, 29]
Oxidative stress	Reduces mitochondrial-induced free radical generation, declines hyperglycemia-dependent oxidative stress, and in turn ameliorates oxidative damages	[13, 18, 25]

Akt = protein kinase B; PEPCK = phosphoenolpyruvate carboxykinase; G6Pase = glucose-6-phosphatase.