Type 2 diabetes, also referred to as non-insulin dependent diabetes mellitus (NIDDM), afflicts between 80 and 90% of all diabetic patients in developed countries. In the United States alone, approximately 15 million people, and more than 100 million worldwide, are affected. Because this disorder is a late onset disease and occurs often in overweight persons, it can be expected that the number of patients suffering from this disease will increase further. Patients suffering from type 2 diabetes usually still produce insulin but become increasingly resistant to their own insulin and to insulin therapy.
A new class of drugs has been recently introduced that resensitizes patients to their own insulin (insulin sensitizers), thereby reducing blood glucose and triglyceride levels, and thus abolishing, or at least reducing, the requirement for exogenous insulin. Troglitazone (Resulin™) and rosiglitazone (Avandia™) were among the first representatives of this class of drugs approved for the treatment of type 2 diabetes in the United States and several other countries. The currently approved compounds can however have side effects including rare but severe liver toxicities and they can increase body weight in humans. Such side effects are of major concern for diabetes patients who can require treatment for a decade or longer. Therefore, new and better drugs for the treatment of type 2 diabetes and related disorders are needed. In particular, drugs that can control blood sugar levels and simultaneously control hyperlipidemia and hypercholesterolemia are desirable. Elevated levels of cholesterol lead to atherosclerosis and heart disease which in many type 2 diabetes patients is the cause of death.
There is also a need for the more effective drugs to treat diseases of uncontrolled cellular proliferation, such as cancers. Certain molecules that have strong cellular differentiation activity can inhibit the uncontrolled cellular proliferation of cancer cells, in particular breast cancer.
Small molecules that can be effective for the treatment of diabetes and/or disorders of carbohydrate metabolism were disclosed in U.S. Pat. No. 6,515,003, issued Feb. 4, 2003, based on U.S. patent application Ser. No. 09/652,810, filed Aug. 31, 2000, which claimed priority to U.S. Provisional Patent Application 60/151,670, filed Aug. 31, 1999. Related small molecules that can be useful in the treatment of certain cancers were disclosed in PCT Patent Application WO 01/16122, published Mar. 8, 2001, which claimed priority to the same U.S. Provisional Patent Application 60/151,670 cited above. The disclosures of all the above-described patent documents are hereby incorporated herein by this reference, for both their chemical structural disclosures, their teachings of the biological activities of those compounds, and methods for their use as pharmaceutical compositions.
There is however a continuing need for effective drugs for the treatment of cancers, and for the treatment of type 2 diabetes and associated disorders of carbohydrate and/or lipid metabolism, including hyperlipidemia and hypercholesterolemia. In particular, there is a continuing need new drugs that can control the blood sugar levels of diabetics, and simultaneously control hyperlipidemia and hypercholesterolemia so as to lessen or prevent atherosclerosis.