A Diabetic Case of Occasional Hemorrhoidal Bleeding with Clinical Improvement by Imeglimin (Twymeeg)

Bando H, Iwatsuki N, Okada M, Ogawa T and Sakamoto K

Published on: 2026-01-13

Abstract

The case was a 56-year-old male with type 2 diabetes (T2D), obesity, hypertension and dyslipidemia. By super-low carbohydrate diet (LCD), his BMI decreased from 34.8 to 30.1 kg/m². HbA1c increased to 7.7%, and the imeglimin (Twymeeg) was started. In February 2023, he was asymptomatic and found for anemia 7.9 g/dL and MCV 73.0 fL. The cause was hemorrhoidal bleeding, and he was recovered by taking sodium ferrous citrate. In October 2025, he developed acute heavy hemorrhoidal bleeding with Hb 7.4 g/dL and MCV 90.2fL. He was hospitalized and treated. Currently, he has been stable with treatment for several medical problems.