Patent Publication Number: US-2019192463-A1

Title: Methods and compositions for the treatment of diabetes and related systems

Description:
This application claims priority benefit of U.S. Provisional Patent Application No. 61/629,633, filed Nov. 21, 2011. The entire content of that application is hereby incorporated by reference herein in its entirety. 
    
    
     FIELD OF THE INVENTION 
     The present invention is directed to methods and compositions for the treatment of diabetes and related symptoms. It is more specifically directed to compositions including L-glutamine, its salts, or its derivatives, and uses of such compositions in the treatment of diabetes and related symptoms. 
     BACKGROUND OF THE INVENTION 
     Diabetes mellitus, also referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar levels. A person with diabetes either does not produce enough insulin to regulate blood sugar levels, or the person&#39;s cells do not respond properly to the insulin that is produced. 
     There are three primary types of diabetes: Type 1; Type 2; and, gestational diabetes. Type 1 diabetes results from the body&#39;s inability to produce insulin. Type 2 diabetes is the result of insulin resistance; a person&#39;s cells fail to use insulin properly. Gestational diabetes is experienced by certain women during pregnancy, where there was no prior history of Type 2 diabetes. 
     Diabetes is diagnosed through measurements obtained through one or more blood tests. For instance, the following tests and related values are typically indicative of diabetes: a fasting plasma glucose level ≥7.0 mmol/L (126 mg/dL); a plasma glucose level ≥11.1 mmol/L (200 mg/dL) two hours after a 75 g oral glucose load (e.g., glucose tolerance test); a casual plasma glucose level ≥11.1 mmol/L (200 mg/dL) in conjunction with symptoms of hyperglycemia; a glycolated hemoglobin (i.e., Hb A1C) level ≥6.5%. 
     Symptoms of hyperglycemia can include, without limitation, excess thirst, fatigue, frequent urination, hunger, weight loss, and hypertriglyceridemia. A person has hypertriglyceridemia if his triglyceride blood levels are over 200 mg/dL; any value over 500 mg/dL is considered to be extremely high. Normal triglyceride levels are typically less than 150 mg/dL. 
     There is a need in the art for additional compositions and methods that can be used to treat diabetes and its related symptoms. That is an object of the present invention. 
    
    
     
       BRIEF DESCRIPTION OF THE FIGURES 
         FIG. 1  shows L-glutamine (1) and L-glutamine salts and derivatives (2). 
     
    
    
     SUMMARY OF THE INVENTION 
     The present invention is directed to methods and compositions for the treatment of diabetes and related symptoms. It is more specifically directed to compositions including L-glutamine, its salts, or its derivatives, and uses of such compositions in the treatment of diabetes and related symptoms. 
     In a method aspect, the present invention provides a method of treating diabetes. The method involves ingesting 0.05 g/kg body weight to 10.0 g/kg body weight of L-glutamine, an L-glutamine salt or an L-glutamine derivative per day by a person who has diabetes. 
     In another method aspect, the present invention provides a method of treating hypertriglyceridemia. The method involves ingesting 0.05 g/kg body weight to 10.0 g/kg body weight of L-glutamine, an L-glutamine salt or an L-glutamine derivative per day by a person who has hypertriglyceridemia. 
     DETAILED DESCRIPTION OF THE INVENTION 
     The present invention is directed to methods and compositions for the treatment of diabetes and related symptoms. It is more specifically directed to compositions including L-glutamine, its salts, or its derivatives, and uses of such compositions in the treatment of diabetes and related symptoms. 
     The structure of L-glutamine is shown in  FIG. 1 , compound 1. L-glutamine salts and derivatives are shown as compound 2 in  FIG. 1 . Nonlimiting L-glutamine salts and derivatives have the following substituents in reference to compound 2: 
     R 1  is NH 2 ; 
     R 2  is NH 2 , NH 3   + , NH 3 Br, NH 3 OPO 3 H, NH 3 OC(O)CH 3  (i.e., acetate salt), NH 3 OC(O)CHCHCO 2 H (i.e., fumarate salt—trans olefin), NH 3 OC(O)CH(OH)CH(OH)CO 2 H (i.e., tartrate salt), NH 3 OC(O)CHCHCO 2 H (i.e., maleate salt cis olefin), NH 3 OC(O)CH 2 —C(OH)(CO 2 H)CH 2 CO 2 H (i.e., citrate salt), NH 3 OC(O)CO 2 H (i.e., oxalate salt), NH 3 OS(O) 2 OH (i.e., methanesulfonate salt), NH 3 OS(O) 2 C 6 H 4 CH 3  p-toluenesulfonate salt), and, NH 3 OC(O)C(O)CH 2 CH 2 CO 2 H (i.e., alpha-ketoglutarate salt). 
     R 3  is OH, O − , ONa, OK, OCa, OLi, ONH 2 (CH 2 C 6 H 5 )CH 2 CH 2 NHCH 2 C 6 H 6  (i.e., benzathine salt), ON(CH 2 CH 3 ) 2 CH 2 CH 2 OC(O)C 6 H 3 ClNH 2  (i.e., chloroprocaine salt), ON(CH 3 ) 3 CH 2 CH 2 OH (i.e., choline salt), ONH 2 (CH 2 CH 2 OH) 2  (i.e., diethanolamine salt), ONH 3 CH 2 CH 2 OH (i.e., ethanolamine salt), ONH 3 CH 2 CH 2 NH 2  (i.e., ethyldiamine salt), ONH 2 (CH 3 )CH 2 CH(OH)CH(OH)CH(OH)CH(OH)CH 2 OH (i.e., meglumine salt), ONH 3 C(CH 2 OH) 3  (i.e., tromethamine salt), ONH 3 C(CH 3 ) 3  (i.e., tertiary-butylamine salt), ON(CH 2 CH 3 ) 2 CH 2 CH 2 OC(O)C 6 H 4 NH 2  (i.e., procaine salt), NHCH(CH 3 )CO 2 H, NHCH(CH(CH 3 ) 2 )CO 2 H, NHCH(CH(CH 3 )(CH 2 CH 3 ))CO 2 H, NHCH(CH 2 CH(CH 3 ) 2 )CO 2 H, NHCH(CH 2 CH 2 SCH 3 )CO 2 H, NHCH(CH 2 C 6 H 5 )CO 2 H, NHCH(CH 2 C 6 H 5 OH)CO 2 H, NHCH(CH 2 C 8 H 6 N)CO 2 H, NHCH 2 CO 2 H, NHCH(CH 2 CH 2 C(O)NH 2 )CO 2 H, NHCH(CH 2 C(O)NH 2 )CO 2 H, NHCH(CH(OH)CH 3 )CO 2 H, NHCH(CH 2 OH)CO 2 H, NHCH(CH 2 CH 2 CO 2 H)CO 2 H, NHCH(CH 2 CO 2 H)CO 2 H. 
     Typically, a single compound (e.g., L-glutamine) is administered to a person seeking treatment for diabetes or its symptoms. In certain cases, however, a mixture of two or more compounds may be administered. For instance, L-glutamine may be administered with one or more L-glutamine salts or derivatives. 
     L-glutamine, its salts, derivatives or mixtures may be administered in any suitable way. For example, in certain cases it is administered as an aqueous solution. The solution may only have L-glutamine, salts or derivatives as dissolved ingredients, or it may include other pharmaceutically acceptable compounds. Nonlimiting examples of such compounds include buffers and flavorants. 
     Other, non-limiting examples of ways in which L-glutamine, its salts, derivatives or mixtures may be administered include: as a suspension in a liquid (e.g., water or juice); as a solid, either as a powder or in another form (e.g., pill or capsule); as a mixture with food (e.g., yogurt). As with the aqueous solution, the preceding administration forms may include other pharmaceutically acceptable ingredients. 
     The amount of L-glutamine, salts or derivatives administered according to the present invention typically range from 0.05 g/kg body weight to 10.0 g/kg body weight. Oftentimes, the amount ranges from 0.10 g/kg body weight to 8.0 g/kg body weight. In certain cases, the amount ranges from 0.15 g/kg body weight to 7.0 g/kg body weight. 
     L-glutamine, its salts or derivatives are typically administered to a person once per day. The compounds may, however, be administered more than once per day where indicated. 
     Compositions according to the present invention may be used to treat diabetes as determined by a number of different tests that measure blood sugar levels. After administration of L-glutamine, its salts or derivatives for at least one month, two months, or three months, the fasting plasma glucose level of a person who previously tested at a level ≥7.0 mmol/L is typically reduced to ≤6.9 mmol/L. Oftentimes, it is reduced to ≤6.8 mmol/L or ≤6.7 mmol/L. 
     The plasma glucose level two hours after a 75 g oral glucose load of a person who previously tested at a level ≥11.1 mmol/L is typically reduced to ≤11.0 mmol/L. Oftentimes the level is reduced to ≤10.9 mmol/L or ≤10.8 mmol/L. In certain cases, it is reduced to ≤10.7 mmol/L. 
     The glycolated hemoglobin level of a person who previously tested at a level ≥6.5% is typically reduced to ≤6.4%. Oftentimes the level is reduced to ≤6.3% or ≤6.2%. In certain cases, it is reduced to ≤6.1%. 
     Compositions according to the present invention may also be used to treat certain symptoms of diabetes, including hypertriglyceridemia. After administration of L-glutamine, its salts or derivatives for at least one month, two months or three months, the triglyceride level of a person who previously tested at a blood level over 500 mg/dL is typically reduced to less than 200 mg/dL. In certain cases, the triglyceride blood level is reduced to less than 180 mg/dL or 160 mg/dL. The triglyceride level of a person who previously tested at a blood level over 200 mg/dL is typically reduced to less than 200 mg/dL or less than 190 mg/dL. Oftentimes, the triglyceride level is reduced to less than 180 mg/dL, 170 mg/dL, 160 mg/dL or 150 mg/dL. 
     Where compositions of the present invention are used to treat diabetes, they may be combined with other methods used to treat diabetes. For instance, the compositions may be administered in conjunction with insulin sensitizers, secretagogues and/or alpha-glucosidase inhibitors. Nonlimiting examples of insulin sensitizers include: biguanides (e.g., metformin (Glucophage)); thiazolidinediones (e.g., rosiglitazone (Avandia), pioglitazone (Actos)). Nonlimiting examples of secretagogues include: sulfonylureas (e.g., tolbutamide (Orinase), acetohexamide (Dymelor), tolazamide (Tolinase), chlorpropamide (Diabinese), glipizide (Glucotrol), glyburide (Diabeta, Micronase, Glynase), glimepiride (Amaryl), and gliclazide (Diamicron)); and nonsulfonylureas (e.g., repaglinide (Prandin) and nateglinide (Starlix)). Nonlimiting examples of alpha-glucosidase inhibitors include: miglitol (Glyset); and, acarbose (Precose/Glucobay). 
     Where compositions of the present invention are used to treat hypertriglyceridemia, they may be combined with other methods used to treat hypertriglyceridemia. For instance, the compositions may be administered in conjunction with statins, fibrates, niacin, fish oil, and prescription omega-3-acid ethyl esters. Nonlimiting examples of statins include: atorvastatin (Lipitor); fluvastatin (Lescol); lovastatin (Mevacor); pravastatin (Pravachol); rosuvastatin (Crestor); and, simvastatin (Zocor). Nonlimiting examples of fibrates include: fenofibrate (Tricor); and, gemfibrozil (Lopid). A nonlimiting example of prescription omega-3-acid ethyl esters include Omacor. 
     Experimental Results 
     HA1C Lowering 
     A person had a measured glycolated hemoglobin level (i.e., Hb A1C level) of 6.9%. The person ingested 30 g of L-glutamine per day as an aqueous solution. After three months of L-glutamine administration, the person&#39;s Hb A1C level was measured at 6.1%. 
     Triglyceride Lowering 
     A person had a measured triglyceride blood level of 500 mg/dL. The person ingested 30 g of L-glutamine per day as an aqueous solution. After three months of L-glutamine administration, the person&#39;s triglyceride blood level was measured at 150 mg/dL.