CN116999398A - An oral composition - Google Patents
An oral composition Download PDFInfo
- Publication number
- CN116999398A CN116999398A CN202310753650.2A CN202310753650A CN116999398A CN 116999398 A CN116999398 A CN 116999398A CN 202310753650 A CN202310753650 A CN 202310753650A CN 116999398 A CN116999398 A CN 116999398A
- Authority
- CN
- China
- Prior art keywords
- active ingredient
- soybean oil
- insulin
- weight ratio
- diabetes
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
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- 239000000203 mixture Substances 0.000 title claims abstract description 20
- 239000004480 active ingredient Substances 0.000 claims abstract description 108
- 239000003549 soybean oil Substances 0.000 claims abstract description 84
- 235000012424 soybean oil Nutrition 0.000 claims abstract description 84
- 229960003105 metformin Drugs 0.000 claims abstract description 21
- XZWYZXLIPXDOLR-UHFFFAOYSA-N metformin Chemical compound CN(C)C(=N)NC(N)=N XZWYZXLIPXDOLR-UHFFFAOYSA-N 0.000 claims abstract description 16
- JAZBEHYOTPTENJ-JLNKQSITSA-N all-cis-5,8,11,14,17-icosapentaenoic acid Chemical compound CC\C=C/C\C=C/C\C=C/C\C=C/C\C=C/CCCC(O)=O JAZBEHYOTPTENJ-JLNKQSITSA-N 0.000 claims abstract description 9
- ICFJFFQQTFMIBG-UHFFFAOYSA-N phenformin Chemical compound NC(=N)NC(=N)NCCC1=CC=CC=C1 ICFJFFQQTFMIBG-UHFFFAOYSA-N 0.000 claims abstract description 7
- 229960003243 phenformin Drugs 0.000 claims abstract description 7
- 239000008194 pharmaceutical composition Substances 0.000 claims description 18
- 206010012601 diabetes mellitus Diseases 0.000 claims description 17
- 239000000314 lubricant Substances 0.000 claims description 14
- 229920002472 Starch Polymers 0.000 claims description 13
- 239000008107 starch Substances 0.000 claims description 13
- 235000019698 starch Nutrition 0.000 claims description 13
- 239000003814 drug Substances 0.000 claims description 12
- 239000001267 polyvinylpyrrolidone Substances 0.000 claims description 12
- 229920000036 polyvinylpyrrolidone Polymers 0.000 claims description 12
- 235000013855 polyvinylpyrrolidone Nutrition 0.000 claims description 12
- NOESYZHRGYRDHS-UHFFFAOYSA-N insulin Chemical compound N1C(=O)C(NC(=O)C(CCC(N)=O)NC(=O)C(CCC(O)=O)NC(=O)C(C(C)C)NC(=O)C(NC(=O)CN)C(C)CC)CSSCC(C(NC(CO)C(=O)NC(CC(C)C)C(=O)NC(CC=2C=CC(O)=CC=2)C(=O)NC(CCC(N)=O)C(=O)NC(CC(C)C)C(=O)NC(CCC(O)=O)C(=O)NC(CC(N)=O)C(=O)NC(CC=2C=CC(O)=CC=2)C(=O)NC(CSSCC(NC(=O)C(C(C)C)NC(=O)C(CC(C)C)NC(=O)C(CC=2C=CC(O)=CC=2)NC(=O)C(CC(C)C)NC(=O)C(C)NC(=O)C(CCC(O)=O)NC(=O)C(C(C)C)NC(=O)C(CC(C)C)NC(=O)C(CC=2NC=NC=2)NC(=O)C(CO)NC(=O)CNC2=O)C(=O)NCC(=O)NC(CCC(O)=O)C(=O)NC(CCCNC(N)=N)C(=O)NCC(=O)NC(CC=3C=CC=CC=3)C(=O)NC(CC=3C=CC=CC=3)C(=O)NC(CC=3C=CC(O)=CC=3)C(=O)NC(C(C)O)C(=O)N3C(CCC3)C(=O)NC(CCCCN)C(=O)NC(C)C(O)=O)C(=O)NC(CC(N)=O)C(O)=O)=O)NC(=O)C(C(C)CC)NC(=O)C(CO)NC(=O)C(C(C)O)NC(=O)C1CSSCC2NC(=O)C(CC(C)C)NC(=O)C(NC(=O)C(CCC(N)=O)NC(=O)C(CC(N)=O)NC(=O)C(NC(=O)C(N)CC=1C=CC=CC=1)C(C)C)CC1=CN=CN1 NOESYZHRGYRDHS-UHFFFAOYSA-N 0.000 claims description 11
- HQKMJHAJHXVSDF-UHFFFAOYSA-L magnesium stearate Chemical compound [Mg+2].CCCCCCCCCCCCCCCCCC([O-])=O.CCCCCCCCCCCCCCCCCC([O-])=O HQKMJHAJHXVSDF-UHFFFAOYSA-L 0.000 claims description 10
- 208000024172 Cardiovascular disease Diseases 0.000 claims description 9
- 239000011734 sodium Substances 0.000 claims description 9
- 229910052708 sodium Inorganic materials 0.000 claims description 9
- 239000000243 solution Substances 0.000 claims description 9
- 238000011282 treatment Methods 0.000 claims description 9
- 239000011230 binding agent Substances 0.000 claims description 8
- 239000002775 capsule Substances 0.000 claims description 8
- 208000008338 non-alcoholic fatty liver disease Diseases 0.000 claims description 8
- 238000002360 preparation method Methods 0.000 claims description 8
- -1 sulfonylurea compound Chemical class 0.000 claims description 8
- HBNDBUATLJAUQM-UHFFFAOYSA-L magnesium;dodecyl sulfate Chemical compound [Mg+2].CCCCCCCCCCCCOS([O-])(=O)=O.CCCCCCCCCCCCOS([O-])(=O)=O HBNDBUATLJAUQM-UHFFFAOYSA-L 0.000 claims description 7
- 239000000546 pharmaceutical excipient Substances 0.000 claims description 7
- 208000001072 type 2 diabetes mellitus Diseases 0.000 claims description 7
- DGAQECJNVWCQMB-PUAWFVPOSA-M Ilexoside XXIX Chemical compound C[C@@H]1CC[C@@]2(CC[C@@]3(C(=CC[C@H]4[C@]3(CC[C@@H]5[C@@]4(CC[C@@H](C5(C)C)OS(=O)(=O)[O-])C)C)[C@@H]2[C@]1(C)O)C)C(=O)O[C@H]6[C@@H]([C@H]([C@@H]([C@H](O6)CO)O)O)O.[Na+] DGAQECJNVWCQMB-PUAWFVPOSA-M 0.000 claims description 6
- 229940124531 pharmaceutical excipient Drugs 0.000 claims description 6
- 239000007884 disintegrant Substances 0.000 claims description 5
- 201000001421 hyperglycemia Diseases 0.000 claims description 5
- 229940037627 magnesium lauryl sulfate Drugs 0.000 claims description 5
- 235000019359 magnesium stearate Nutrition 0.000 claims description 5
- 239000000843 powder Substances 0.000 claims description 5
- 208000002705 Glucose Intolerance Diseases 0.000 claims description 4
- 108090001061 Insulin Proteins 0.000 claims description 4
- 102000004877 Insulin Human genes 0.000 claims description 4
- 208000008589 Obesity Diseases 0.000 claims description 4
- 206010067584 Type 1 diabetes mellitus Diseases 0.000 claims description 4
- 229940125396 insulin Drugs 0.000 claims description 4
- 235000020824 obesity Nutrition 0.000 claims description 4
- 201000009104 prediabetes syndrome Diseases 0.000 claims description 4
- 238000011321 prophylaxis Methods 0.000 claims description 4
- 239000002904 solvent Substances 0.000 claims description 4
- LNAZSHAWQACDHT-XIYTZBAFSA-N (2r,3r,4s,5r,6s)-4,5-dimethoxy-2-(methoxymethyl)-3-[(2s,3r,4s,5r,6r)-3,4,5-trimethoxy-6-(methoxymethyl)oxan-2-yl]oxy-6-[(2r,3r,4s,5r,6r)-4,5,6-trimethoxy-2-(methoxymethyl)oxan-3-yl]oxyoxane Chemical compound CO[C@@H]1[C@@H](OC)[C@H](OC)[C@@H](COC)O[C@H]1O[C@H]1[C@H](OC)[C@@H](OC)[C@H](O[C@H]2[C@@H]([C@@H](OC)[C@H](OC)O[C@@H]2COC)OC)O[C@@H]1COC LNAZSHAWQACDHT-XIYTZBAFSA-N 0.000 claims description 3
- 229920002785 Croscarmellose sodium Polymers 0.000 claims description 3
- 239000001856 Ethyl cellulose Substances 0.000 claims description 3
- ZZSNKZQZMQGXPY-UHFFFAOYSA-N Ethyl cellulose Chemical compound CCOCC1OC(OC)C(OCC)C(OCC)C1OC1C(O)C(O)C(OC)C(CO)O1 ZZSNKZQZMQGXPY-UHFFFAOYSA-N 0.000 claims description 3
- 108010010803 Gelatin Proteins 0.000 claims description 3
- 229920002153 Hydroxypropyl cellulose Polymers 0.000 claims description 3
- 239000002202 Polyethylene glycol Substances 0.000 claims description 3
- VYPSYNLAJGMNEJ-UHFFFAOYSA-N Silicium dioxide Chemical compound O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 claims description 3
- 235000021355 Stearic acid Nutrition 0.000 claims description 3
- 229930006000 Sucrose Natural products 0.000 claims description 3
- CZMRCDWAGMRECN-UGDNZRGBSA-N Sucrose Chemical compound O[C@H]1[C@H](O)[C@@H](CO)O[C@@]1(CO)O[C@@H]1[C@H](O)[C@@H](O)[C@H](O)[C@@H](CO)O1 CZMRCDWAGMRECN-UGDNZRGBSA-N 0.000 claims description 3
- 239000000443 aerosol Substances 0.000 claims description 3
- CJZGTCYPCWQAJB-UHFFFAOYSA-L calcium stearate Chemical compound [Ca+2].CCCCCCCCCCCCCCCCCC([O-])=O.CCCCCCCCCCCCCCCCCC([O-])=O CJZGTCYPCWQAJB-UHFFFAOYSA-L 0.000 claims description 3
- 239000008116 calcium stearate Substances 0.000 claims description 3
- 235000013539 calcium stearate Nutrition 0.000 claims description 3
- 239000003086 colorant Substances 0.000 claims description 3
- 239000001767 crosslinked sodium carboxy methyl cellulose Substances 0.000 claims description 3
- 235000010947 crosslinked sodium carboxy methyl cellulose Nutrition 0.000 claims description 3
- 239000003085 diluting agent Substances 0.000 claims description 3
- 229960005135 eicosapentaenoic acid Drugs 0.000 claims description 3
- JAZBEHYOTPTENJ-UHFFFAOYSA-N eicosapentaenoic acid Natural products CCC=CCC=CCC=CCC=CCC=CCCCC(O)=O JAZBEHYOTPTENJ-UHFFFAOYSA-N 0.000 claims description 3
- 235000020673 eicosapentaenoic acid Nutrition 0.000 claims description 3
- 239000003995 emulsifying agent Substances 0.000 claims description 3
- 239000000839 emulsion Substances 0.000 claims description 3
- 235000019325 ethyl cellulose Nutrition 0.000 claims description 3
- 229920001249 ethyl cellulose Polymers 0.000 claims description 3
- 239000010408 film Substances 0.000 claims description 3
- 235000003599 food sweetener Nutrition 0.000 claims description 3
- 239000003205 fragrance Substances 0.000 claims description 3
- 239000000499 gel Substances 0.000 claims description 3
- 239000008273 gelatin Substances 0.000 claims description 3
- 229920000159 gelatin Polymers 0.000 claims description 3
- 235000019322 gelatine Nutrition 0.000 claims description 3
- 235000011852 gelatine desserts Nutrition 0.000 claims description 3
- 239000008187 granular material Substances 0.000 claims description 3
- 239000001863 hydroxypropyl cellulose Substances 0.000 claims description 3
- 235000010977 hydroxypropyl cellulose Nutrition 0.000 claims description 3
- 239000001866 hydroxypropyl methyl cellulose Substances 0.000 claims description 3
- 235000010979 hydroxypropyl methyl cellulose Nutrition 0.000 claims description 3
- 229920003088 hydroxypropyl methyl cellulose Polymers 0.000 claims description 3
- UFVKGYZPFZQRLF-UHFFFAOYSA-N hydroxypropyl methyl cellulose Chemical compound OC1C(O)C(OC)OC(CO)C1OC1C(O)C(O)C(OC2C(C(O)C(OC3C(C(O)C(O)C(CO)O3)O)C(CO)O2)O)C(CO)O1 UFVKGYZPFZQRLF-UHFFFAOYSA-N 0.000 claims description 3
- 239000007924 injection Substances 0.000 claims description 3
- 238000002347 injection Methods 0.000 claims description 3
- 229940031703 low substituted hydroxypropyl cellulose Drugs 0.000 claims description 3
- 229920000609 methyl cellulose Polymers 0.000 claims description 3
- 239000001923 methylcellulose Substances 0.000 claims description 3
- 235000010981 methylcellulose Nutrition 0.000 claims description 3
- QIQXTHQIDYTFRH-UHFFFAOYSA-N octadecanoic acid Chemical compound CCCCCCCCCCCCCCCCCC(O)=O QIQXTHQIDYTFRH-UHFFFAOYSA-N 0.000 claims description 3
- OQCDKBAXFALNLD-UHFFFAOYSA-N octadecanoic acid Natural products CCCCCCCC(C)CCCCCCCCC(O)=O OQCDKBAXFALNLD-UHFFFAOYSA-N 0.000 claims description 3
- 239000002674 ointment Substances 0.000 claims description 3
- 239000006187 pill Substances 0.000 claims description 3
- 229920001223 polyethylene glycol Polymers 0.000 claims description 3
- 239000000741 silica gel Substances 0.000 claims description 3
- 239000002002 slurry Substances 0.000 claims description 3
- 239000008117 stearic acid Substances 0.000 claims description 3
- 239000005720 sucrose Substances 0.000 claims description 3
- 239000000829 suppository Substances 0.000 claims description 3
- 239000000725 suspension Substances 0.000 claims description 3
- 239000003765 sweetening agent Substances 0.000 claims description 3
- 239000006188 syrup Substances 0.000 claims description 3
- 235000020357 syrup Nutrition 0.000 claims description 3
- 239000003826 tablet Substances 0.000 claims description 3
- 229940100389 Sulfonylurea Drugs 0.000 claims description 2
- 239000003472 antidiabetic agent Substances 0.000 claims description 2
- 239000000825 pharmaceutical preparation Substances 0.000 claims description 2
- 229910002027 silica gel Inorganic materials 0.000 claims description 2
- YROXIXLRRCOBKF-UHFFFAOYSA-N sulfonylurea Chemical class OC(=N)N=S(=O)=O YROXIXLRRCOBKF-UHFFFAOYSA-N 0.000 claims description 2
- 229940124213 Dipeptidyl peptidase 4 (DPP IV) inhibitor Drugs 0.000 claims 2
- 101000976075 Homo sapiens Insulin Proteins 0.000 claims 2
- 208000031226 Hyperlipidaemia Diseases 0.000 claims 2
- YASAKCUCGLMORW-UHFFFAOYSA-N Rosiglitazone Chemical compound C=1C=CC=NC=1N(C)CCOC(C=C1)=CC=C1CC1SC(=O)NC1=O YASAKCUCGLMORW-UHFFFAOYSA-N 0.000 claims 2
- 108091006299 SLC2A2 Proteins 0.000 claims 2
- 229940123464 Thiazolidinedione Drugs 0.000 claims 2
- 230000001419 dependent effect Effects 0.000 claims 2
- 239000003603 dipeptidyl peptidase IV inhibitor Substances 0.000 claims 2
- 239000003877 glucagon like peptide 1 receptor agonist Substances 0.000 claims 2
- 239000003316 glycosidase inhibitor Substances 0.000 claims 2
- 239000003112 inhibitor Substances 0.000 claims 2
- PBGKTOXHQIOBKM-FHFVDXKLSA-N insulin (human) Chemical compound C([C@@H](C(=O)N[C@@H](CC(C)C)C(=O)N[C@H]1CSSC[C@H]2C(=O)N[C@H](C(=O)N[C@@H](CO)C(=O)N[C@H](C(=O)N[C@H](C(N[C@@H](CO)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CC=3C=CC(O)=CC=3)C(=O)N[C@@H](CCC(N)=O)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CCC(O)=O)C(=O)N[C@@H](CC(N)=O)C(=O)N[C@@H](CC=3C=CC(O)=CC=3)C(=O)N[C@@H](CSSC[C@H](NC(=O)[C@H](C(C)C)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CC=3C=CC(O)=CC=3)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](C)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](C(C)C)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CC=3NC=NC=3)NC(=O)[C@H](CO)NC(=O)CNC1=O)C(=O)NCC(=O)N[C@@H](CCC(O)=O)C(=O)N[C@@H](CCCNC(N)=N)C(=O)NCC(=O)N[C@@H](CC=1C=CC=CC=1)C(=O)N[C@@H](CC=1C=CC=CC=1)C(=O)N[C@@H](CC=1C=CC(O)=CC=1)C(=O)N[C@@H]([C@@H](C)O)C(=O)N1[C@@H](CCC1)C(=O)N[C@@H](CCCCN)C(=O)N[C@@H]([C@@H](C)O)C(O)=O)C(=O)N[C@@H](CC(N)=O)C(O)=O)=O)CSSC[C@@H](C(N2)=O)NC(=O)[C@H](CCC(N)=O)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](C(C)C)NC(=O)[C@@H](NC(=O)CN)[C@@H](C)CC)[C@@H](C)CC)[C@@H](C)O)NC(=O)[C@H](CCC(N)=O)NC(=O)[C@H](CC(N)=O)NC(=O)[C@@H](NC(=O)[C@@H](N)CC=1C=CC=CC=1)C(C)C)C1=CN=CN1 PBGKTOXHQIOBKM-FHFVDXKLSA-N 0.000 claims 2
- XUFXOAAUWZOOIT-SXARVLRPSA-N (2R,3R,4R,5S,6R)-5-[[(2R,3R,4R,5S,6R)-5-[[(2R,3R,4S,5S,6R)-3,4-dihydroxy-6-methyl-5-[[(1S,4R,5S,6S)-4,5,6-trihydroxy-3-(hydroxymethyl)-1-cyclohex-2-enyl]amino]-2-oxanyl]oxy]-3,4-dihydroxy-6-(hydroxymethyl)-2-oxanyl]oxy]-6-(hydroxymethyl)oxane-2,3,4-triol Chemical compound O([C@H]1O[C@H](CO)[C@H]([C@@H]([C@H]1O)O)O[C@H]1O[C@@H]([C@H]([C@H](O)[C@H]1O)N[C@@H]1[C@@H]([C@@H](O)[C@H](O)C(CO)=C1)O)C)[C@@H]1[C@@H](CO)O[C@@H](O)[C@H](O)[C@H]1O XUFXOAAUWZOOIT-SXARVLRPSA-N 0.000 claims 1
- BOVGTQGAOIONJV-BETUJISGSA-N 1-[(3ar,6as)-3,3a,4,5,6,6a-hexahydro-1h-cyclopenta[c]pyrrol-2-yl]-3-(4-methylphenyl)sulfonylurea Chemical compound C1=CC(C)=CC=C1S(=O)(=O)NC(=O)NN1C[C@H]2CCC[C@H]2C1 BOVGTQGAOIONJV-BETUJISGSA-N 0.000 claims 1
- LLJFMFZYVVLQKT-UHFFFAOYSA-N 1-cyclohexyl-3-[4-[2-(7-methoxy-4,4-dimethyl-1,3-dioxo-2-isoquinolinyl)ethyl]phenyl]sulfonylurea Chemical compound C=1C(OC)=CC=C(C(C2=O)(C)C)C=1C(=O)N2CCC(C=C1)=CC=C1S(=O)(=O)NC(=O)NC1CCCCC1 LLJFMFZYVVLQKT-UHFFFAOYSA-N 0.000 claims 1
- NKOHRVBBQISBSB-UHFFFAOYSA-N 5-[(4-hydroxyphenyl)methyl]-1,3-thiazolidine-2,4-dione Chemical compound C1=CC(O)=CC=C1CC1C(=O)NC(=O)S1 NKOHRVBBQISBSB-UHFFFAOYSA-N 0.000 claims 1
- JVHXJTBJCFBINQ-ADAARDCZSA-N Dapagliflozin Chemical compound C1=CC(OCC)=CC=C1CC1=CC([C@H]2[C@@H]([C@@H](O)[C@H](O)[C@@H](CO)O2)O)=CC=C1Cl JVHXJTBJCFBINQ-ADAARDCZSA-N 0.000 claims 1
- 108010011459 Exenatide Proteins 0.000 claims 1
- HTQBXNHDCUEHJF-XWLPCZSASA-N Exenatide Chemical compound C([C@@H](C(=O)N[C@@H]([C@@H](C)CC)C(=O)N[C@@H](CCC(O)=O)C(=O)N[C@@H](CC=1C2=CC=CC=C2NC=1)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CCCCN)C(=O)N[C@@H](CC(N)=O)C(=O)NCC(=O)NCC(=O)N1[C@@H](CCC1)C(=O)N[C@@H](CO)C(=O)N[C@@H](CO)C(=O)NCC(=O)N[C@@H](C)C(=O)N1[C@@H](CCC1)C(=O)N1[C@@H](CCC1)C(=O)N1[C@@H](CCC1)C(=O)N[C@@H](CO)C(N)=O)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CCCNC(N)=N)NC(=O)[C@@H](NC(=O)[C@H](C)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](CCSC)NC(=O)[C@H](CCC(N)=O)NC(=O)[C@H](CCCCN)NC(=O)[C@H](CO)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CC(O)=O)NC(=O)[C@H](CO)NC(=O)[C@@H](NC(=O)[C@H](CC=1C=CC=CC=1)NC(=O)[C@@H](NC(=O)CNC(=O)[C@H](CCC(O)=O)NC(=O)CNC(=O)[C@@H](N)CC=1NC=NC=1)[C@@H](C)O)[C@@H](C)O)C(C)C)C1=CC=CC=C1 HTQBXNHDCUEHJF-XWLPCZSASA-N 0.000 claims 1
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- COCFEDIXXNGUNL-RFKWWTKHSA-N Insulin glargine Chemical compound C([C@@H](C(=O)N[C@@H](CC(C)C)C(=O)N[C@H]1CSSC[C@H]2C(=O)N[C@H](C(=O)N[C@@H](CO)C(=O)N[C@H](C(=O)N[C@H](C(N[C@@H](CO)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CC=3C=CC(O)=CC=3)C(=O)N[C@@H](CCC(N)=O)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CCC(O)=O)C(=O)N[C@@H](CC(N)=O)C(=O)N[C@@H](CC=3C=CC(O)=CC=3)C(=O)N[C@@H](CSSC[C@H](NC(=O)[C@H](C(C)C)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CC=3C=CC(O)=CC=3)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](C)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](C(C)C)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CC=3NC=NC=3)NC(=O)[C@H](CO)NC(=O)CNC1=O)C(=O)NCC(=O)N[C@@H](CCC(O)=O)C(=O)N[C@@H](CCCNC(N)=N)C(=O)NCC(=O)N[C@@H](CC=1C=CC=CC=1)C(=O)N[C@@H](CC=1C=CC=CC=1)C(=O)N[C@@H](CC=1C=CC(O)=CC=1)C(=O)N[C@@H]([C@@H](C)O)C(=O)N1[C@@H](CCC1)C(=O)N[C@@H](CCCCN)C(=O)N[C@@H]([C@@H](C)O)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](CCCNC(N)=N)C(O)=O)C(=O)NCC(O)=O)=O)CSSC[C@@H](C(N2)=O)NC(=O)[C@H](CCC(N)=O)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](C(C)C)NC(=O)[C@@H](NC(=O)CN)[C@@H](C)CC)[C@@H](C)CC)[C@@H](C)O)NC(=O)[C@H](CCC(N)=O)NC(=O)[C@H](CC(N)=O)NC(=O)[C@@H](NC(=O)[C@@H](N)CC=1C=CC=CC=1)C(C)C)C1=CN=CN1 COCFEDIXXNGUNL-RFKWWTKHSA-N 0.000 claims 1
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Abstract
Aiming at the existing problems, the invention provides an oral composition which comprises an active ingredient and soybean oil, wherein the active ingredient comprises metformin and/or eicosapentaenoate of phenformin, and the active ingredient and the soybean oil can reduce blood sugar in a synergistic way, so that the blood sugar reducing effect of the active ingredient can be remarkably improved.
Description
Technical Field
The invention belongs to the field of diabetes treatment, and particularly relates to an oral composition.
Background
Diabetes is a chronic metabolic disease that severely threatens global health. The ninth version of IDF shows that 4.63 million adults currently have diabetes. If adequate countermeasures were not taken, by 2030, global diabetics would reach 5.78 million people and by 2045 would jump to a striking 7 million.
Biguanides are important drugs for the treatment of diabetes, and common biguanides include metformin and phenformin, which act by reducing liver glycogen production, inhibiting glucose absorption in the intestinal tract, and increasing peripheral resistance to glucose absorption and utilization, and increase insulin sensitivity by increasing peripheral sugar uptake and utilization.
Metformin is a primary medication in first-line and drug combination for controlling hyperglycemia in patients with T2DM and is recommended by guidelines for diabetes treatment in various countries around the world. The 2020 edition of Chinese guidelines for the prevention and treatment of type II diabetes indicates that metformin is currently the most commonly used hypoglycemic agent, has potential benefits beyond various hypoglycemic effects (such as treatment of cardiovascular diseases, diabetic cardiovascular complications, etc.), and does not increase the risk of hypoglycemia. If there is no contraindication, metformin should remain in the treatment regimen for diabetes.
The metformin can be used for treating type 2 diabetes with simple diet and physical exercise for controlling blood sugar inefficiency, and can also be used for treating with sulfonylurea drugs or insulin. The chemical formula of the metformin is:
it is therefore always a pursuit of the person skilled in the art if the therapeutic effect of eicosapentaenoic acid salts of metformin is improved.
Disclosure of Invention
1. Problems to be solved
Aiming at the existing problems, the invention provides an oral composition which comprises an active ingredient and soybean oil, wherein the active ingredient comprises metformin and/or eicosapentaenoate of phenformin, and the active ingredient and the soybean oil can reduce blood sugar in a synergistic way, so that the blood sugar reducing effect of the active ingredient can be remarkably improved.
2. Technical proposal
In order to solve the problems, the invention adopts the following technical scheme.
In a first aspect the present invention provides an oral composition comprising an active ingredient comprising metformin and/or an eicosapentaenoate salt of phenformin and soybean oil.
Preferably, the weight ratio of the active ingredient to the soybean oil is 100: (50 to 1000), preferably 100: (50 to 400), preferably 100: (400-1000).
Preferably, the weight of the active ingredient and the soybean oil is
100mg of active ingredient
Soybean oil 50mg
Or (b)
100mg of active ingredient
Soybean oil 400mg
Or (b)
100mg of active ingredient
Soybean oil 1000mg.
In a second aspect, the present invention provides a pharmaceutical formulation comprising any of the above oral compositions and a pharmaceutically acceptable adjuvant.
Preferably, the pharmaceutical excipients comprise binders, disintegrants or lubricants, preferably, the pharmaceutical excipients further comprise diluents, emulsifiers, solubilizers, colorants, fragrances or sweeteners.
Preferably, the weight ratio of the binder, the lubricant and the disintegrating agent is:
adhesive 0-4
Lubricant 0-20
0 to 6 portions of disintegrating agent
Or (b)
Adhesive 0-3
Lubricant 0-10
0 to 3 portions of disintegrating agent
Or (b)
3 to 4 of adhesive
10 to 20 portions of lubricant
3 to 6 portions of disintegrating agent.
Preferably, the binder is selected from one or more of starch slurry, gelatin solution, sucrose solution, polyvinylpyrrolidone, methylcellulose, ethylcellulose, hydroxypropyl cellulose or hydroxypropyl methylcellulose, preferably, the disintegrating agent is selected from one or more of carboxymethyl starch sodium, dry starch, low-substituted hydroxypropyl cellulose, crosslinked sodium carboxymethyl cellulose or crosslinked polyvinylpyrrolidone, preferably, the lubricant is selected from one or more of talcum powder, micro silica gel, magnesium lauryl sulfate, polyethylene glycol, magnesium lauryl sulfate, stearic acid, calcium stearate or magnesium stearate.
Preferably, the dosage form of the pharmaceutical preparation is tablets, capsules, powder, granules, capsules, pills, suppositories, ointments, gels, aerosols, films, syrups, emulsions, suspensions or injections.
In a third aspect, the invention provides an oral composition as described in any one of the above, and the use of a pharmaceutical formulation as described in any one of the above for the preparation of a medicament for the treatment or prophylaxis of hyperglycemia, type 2 diabetes, type 1 diabetes, obesity, impaired glucose tolerance, diabetes with non-alcoholic fatty liver, diabetic cardiovascular disease, cardiovascular disease or non-alcoholic fatty liver.
3. Advantageous effects
Compared with the prior art, the invention has the beneficial effects that:
(1) The oral composition of the invention can obviously improve the hypoglycemic effect of the eicosapentaenoate of the metformin and/or the phenformin.
Detailed Description
In a first aspect the present invention provides an oral composition comprising an active ingredient comprising metformin and/or an eicosapentaenoate salt of phenformin and soybean oil.
In one embodiment, the weight ratio of the active ingredient to soybean oil is 100:50.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:55.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:60.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:65.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:70.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:75.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:80.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:85.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:90.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:95.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:100.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:110.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:120.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:130.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:150.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:170.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:190.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:200.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:220.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:230.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:240.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:250.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:270.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:300.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:310.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:320.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:350.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:370.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:390.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:400.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:430.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:450.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:470.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:480.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:500.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:520.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:550.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:600.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:650.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:700.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:750.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:800.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:850.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:900.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:950.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:1000.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:2000.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:3000.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:4000.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:5000.
in one embodiment, the weight ratio of the active ingredient to soybean oil is 100:6000.
in one embodiment, the active ingredient weight is 5 mg/dose.
In one embodiment, the active ingredient weight is 10 mg/dose.
In one embodiment, the active ingredient weight is 20 mg/dose.
In one embodiment, the active ingredient weight is 30 mg/dose.
In one embodiment, the active ingredient weight is 40 mg/dose.
In one embodiment, the active ingredient weight is 50 mg/dose.
In one embodiment, the active ingredient weight is 70 mg/dose.
In one embodiment, the active ingredient weight is 100 mg/dose.
In one embodiment, the active ingredient weight is 130 mg/dose.
In one embodiment, the active ingredient weight is 200 mg/dose.
In one embodiment, the active ingredient weight is 250 mg/dose.
In one embodiment, the active ingredient weight is 300 mg/dose.
In one embodiment, the active ingredient weight is 400 mg/dose.
In one embodiment, the active ingredient weight is 500 mg/dose.
In one embodiment, the active ingredient weight is 600 mg/dose.
In one embodiment, the active ingredient weight is 700 mg/dose.
In one embodiment, the active ingredient weight is 800 mg/dose.
In one embodiment, the active ingredient weight is 900 mg/dose.
In one embodiment, the active ingredient weight is 1000 mg/dose.
In one embodiment, the active ingredient weight is 1100 mg/dose.
In one embodiment, the active ingredient weight is 1200 mg/dose.
In one embodiment, the active ingredient weight is 1300 mg/dose.
In one embodiment, the active ingredient weight is 1400 mg/dose.
In one embodiment, the active ingredient weight is 1500 mg/dose.
In one embodiment, the active ingredient weighs 1600 mg/dose.
In one embodiment, the active ingredient weight is 1700 mg/dose.
In one embodiment, the active ingredient weight is 1800 mg/dose.
In one embodiment, the active ingredient weighs 2000 mg/dose.
In one embodiment, the weight of the active ingredient and soybean oil is
100mg of active ingredient
Soybean oil 50mg
Or (b)
100mg of active ingredient
Soybean oil 400mg
Or (b)
100mg of active ingredient
Soybean oil 1000mg.
In a second aspect, the present invention provides a pharmaceutical formulation comprising any of the above oral compositions and a pharmaceutically acceptable adjuvant.
In one embodiment, the pharmaceutical excipients comprise a binder, disintegrant or lubricant, preferably, the pharmaceutical excipients further comprise a diluent, emulsifier, solubilizer, colorant, fragrance or sweetener.
In one embodiment, the binder, lubricant and disintegrant are present in a weight ratio of:
adhesive 0-4
Lubricant 0-20
0 to 6 portions of disintegrating agent
Or (b)
Adhesive 0-3
Lubricant 0-10
0 to 3 portions of disintegrating agent
Or (b)
3 to 4 of adhesive
10 to 20 portions of lubricant
3 to 6 portions of disintegrating agent.
In one embodiment, the binder is selected from one or more of starch slurry, gelatin solution, sucrose solution, polyvinylpyrrolidone, methyl cellulose, ethyl cellulose, hydroxypropyl cellulose or hydroxypropyl methyl cellulose, preferably, the disintegrating agent is selected from one or more of carboxymethyl starch sodium, dry starch, low-substituted hydroxypropyl cellulose, cross-linked sodium carboxymethyl cellulose or cross-linked polyvinylpyrrolidone, preferably, the lubricant is selected from one or more of talcum powder, micro powder silica gel, magnesium lauryl sulfate, polyethylene glycol, magnesium dodecyl sulfate, stearic acid, calcium stearate or magnesium stearate.
In one embodiment, the pharmaceutical formulation is in the form of a tablet, capsule, powder, granule, capsule, pill, suppository, ointment, gel, aerosol, film, syrup, emulsion, suspension, or injection.
In a third aspect, the invention provides an oral composition as described in any one of the above, and the use of a pharmaceutical formulation as described in any one of the above for the preparation of a medicament for the treatment or prophylaxis of hyperglycemia, type 2 diabetes, type 1 diabetes, obesity, impaired glucose tolerance, diabetes with non-alcoholic fatty liver, diabetic cardiovascular disease, cardiovascular disease or non-alcoholic fatty liver.
Example 1
Preparation of metformin eicosapentaenoate
The structure of eicosapentaenoic acid is as follows
Commercial metformin hydrochloride is dissolved in 1mo/L aqueous sodium hydroxide solution, stirred for half an hour, ethanol is added, the solvent is removed by rotary evaporation, then ethanol is added, sodium chloride is removed by filtration, and the filtrate is rotary evaporated to obtain metformin free base.
Weighing 1mol of metformin free alkali, adding a proper amount of acetonitrile for dissolution, filtering to remove sodium chloride, slowly dripping 0.9mol of eicosapentaenoic acid solution (dissolved in acetonitrile) into the filtrate, stirring, cooling to 0-5 ℃, and filtering under the protection of nitrogen and in the absence of light to obtain light tan solid, namely the metformin eicosapentaenoic acid salt.
Example 2
Preparation of pharmaceutical compositions
Prescription (1000 pieces)
Raw and auxiliary materials | Prescription quantity (g) |
Metformin eicosapentaenoic acid salt | 100 |
Soybean oil | 50 |
Polyvinylpyrrolidone | 3 |
Dodecyl sulfuric acidMagnesium (Mg) | 10 |
Sodium carboxymethyl starch | 6 |
Weighing raw materials and auxiliary materials according to the prescription amount, sieving 100g of metformin eicosapentaenoate with a 80-mesh sieve, adding 6g of carboxymethyl starch sodium, mixing, adding 50g of soybean oil and a polyvinylpyrrolidone water solution (prepared by 3g of polyvinylpyrrolidone and purified water) with the mass fraction of 3%, stirring uniformly, sieving, granulating, putting into a hot air circulation oven after granulating, drying at 50 ℃ for 0.5h, sieving with a 14-mesh sieve, finishing granulating, adding into a three-dimensional mixer after finishing granulating, adding 10g of magnesium dodecyl sulfate, 50 revolutions per minute, mixing for 1h, finishing mixing, and tabletting to obtain the metformin eicosapentaenoate soybean oil composition.
Example 3
Preparation of pharmaceutical compositions
Prescription (1000 capsules)
Weighing the raw materials and the auxiliary materials according to the prescription, sieving 100g of metformin eicosapentaenoic acid salt with a 80-mesh sieve, adding 400g of soybean oil, uniformly stirring, and filling into capsules after the mixing is finished to obtain the metformin eicosapentaenoic acid salt soybean oil composition.
Example 4
Preparation of pharmaceutical compositions
Prescription (1000 pieces)
Raw and auxiliary materials | Prescription quantity (g) |
Metformin eicosapentaenoic acid salt | 100 |
Soybean oil | 1000 |
Polyvinylpyrrolidone | 4 |
Magnesium stearate | 20 |
Sodium carboxymethyl starch | 3 |
Weighing raw materials and auxiliary materials according to the prescription amount, sieving 100g of metformin eicosapentaenoate with a 80-mesh sieve, adding 3g of carboxymethyl starch sodium, mixing, adding 1000g of soybean oil and 5% by mass of polyvinylpyrrolidone aqueous solution (prepared from 4g of polyvinylpyrrolidone and purified water), stirring uniformly, sieving, granulating, putting into a hot air circulation oven after granulating is finished, drying at 60 ℃ for 1h, sieving with a 14-mesh sieve, finishing granulating, adding into a three-dimensional mixer, adding 20g of magnesium stearate, 50 revolutions per minute, mixing for 1h, finishing mixing, tabletting, and obtaining the metformin eicosapentaenoate soybean oil composition.
Example 5
Animal experiment
The experimental method comprises the following steps:
establishment of diabetes model mice:
70 rats are fasted for 6 hours, and are injected with streptozotocin intraperitoneally at the dosage of 40mg/kg once a day, and are fed with high-fat feed, and the fasting blood glucose is measured by a Roche glucometer, and the fasting blood glucose value is more than 11.1mmol/L, so that the molding is successful. Model mice were randomly divided into 6 groups of 10 mice each. Another 10 non-model rats were taken as a normal control group.
Experimental grouping:
normal control group: 10 normal rats without molding are subcutaneously injected with physiological saline;
model control group: 10 model mice were subcutaneously injected with physiological saline;
drug group:
the pharmaceutical compositions prepared in examples 1-4 were administered before each group had been given the gastric-unaged drug, the fasting blood glucose was measured with a glucometer, each group had been given the gastric-unaged drug, and after each group had been given the drug, the drug was given the following free water and was fed with the high-fat feed, and after the 10d administration, the tail was cut to obtain blood, and the blood glucose of each rat was measured with the glucometer to obtain the average blood glucose value of the corresponding group of 10 rats, with the following specific dosing regimen:
group A: 10 model rats were given the pharmaceutical composition prepared in example 2 by gavage at 20mg/kg of body weight of the rats once daily for 10 consecutive days;
group B: 10 model rats were given the pharmaceutical composition prepared in example 3 by gavage at 20mg/kg of body weight of the rats once daily for 10 consecutive days;
group C: the pharmaceutical composition prepared in example 4 was administered once daily for 10 consecutive days in 10 model rats by gavage of 20mg/kg rat body weight;
group D: model 10 mice were dosed once daily for 10 consecutive days with metformin eicosapentaenoic acid salt prepared in example 1 by gavage of 20mg/kg of rat body weight;
group E: the model rats were given 10 rats per day with soybean oil commercially available by gavage at 20mg/kg of body weight for 10 consecutive days.
The experimental results are shown in the following table
Time/group | Group A | Group B | Group C |
0d | 18.3±3.1 | 17.2±3.2 | 17.0±3.7 |
10d | 7.1±1.5 | 6.7±3.4 | 7.5±2.3 |
Time/group | Group D | Group E | Normal control group | Model control group |
0d | 18.6±2.0 | 17.5±2.6 | 5.2±2.2 | 18.3±3.1 |
10d | 10.3±1.9 | 18.3±2.0 | 6.0±2.4 | 19.0±2.5 |
Wherein, P <0.01 in the normal control group compared with the model control group indicates that the diabetes modeling is successful.
The E group has no obvious difference from the model control group, and shows that the soybean oil alone has poor hypoglycemic effect.
Group a, group B, group C, group D have P <0.01 compared to the model control group.
Group a, group B, group C and group D compare with P <0.05.
Therefore, the combined use of the metformin eicosapentaenoate and the soybean oil can achieve remarkable hypoglycemic effect and play a synergistic effect.
Claims (10)
1. An oral composition comprising an active ingredient and soybean oil, the active ingredient comprising metformin and/or a salt of eicosapentaenoic acid of phenformin, the weight ratio of the active ingredient to the soybean oil being 100: (50-1000).
2. The oral composition of claim 1, wherein the weight ratio of active ingredient to soybean oil is 100: (50 to 400), preferably 100: (400-1000).
3. The oral composition of claim 1, wherein the weight of the active ingredient and soybean oil is
100mg of active ingredient
Soybean oil 50mg
Or (b)
100mg of active ingredient
Soybean oil 400mg
Or (b)
100mg of active ingredient
Soybean oil 1000mg.
4. Pharmaceutical formulation, characterized in that it comprises an oral composition according to any one of claims 1 to 3 and a pharmaceutical adjuvant.
5. The pharmaceutical formulation according to claim 4, wherein the pharmaceutical excipients comprise binders, disintegrants or lubricants, preferably the pharmaceutical excipients further comprise diluents, emulsifiers, solubilizers, colorants, fragrances or sweeteners.
6. The pharmaceutical preparation according to claim 5, wherein the binder is selected from one or more of starch slurry, gelatin solution, sucrose solution, polyvinylpyrrolidone, methylcellulose, ethylcellulose, hydroxypropyl cellulose or hydroxypropyl methylcellulose, preferably the disintegrant is selected from one or more of sodium carboxymethyl starch, dry starch, low substituted hydroxypropyl cellulose, cross-linked sodium carboxymethyl cellulose or cross-linked polyvinylpyrrolidone, preferably the lubricant is selected from one or more of talc, micro powder silica gel, magnesium lauryl sulfate, polyethylene glycol, magnesium lauryl sulfate, stearic acid, calcium stearate or magnesium stearate.
7. The pharmaceutical formulation according to any one of claims 4 to 6, wherein the pharmaceutical formulation is in the form of a tablet, capsule, powder, granule, capsule, pill, suppository, ointment, gel, aerosol, film, syrup, emulsion, suspension or injection.
8. The pharmaceutical formulation according to any one of claims 4-7, further comprising a second active ingredient, which is a hypoglycemic drug, preferably, the second active ingredient comprises any one or a combination of insulin, insulin analogues, glycosidase inhibitors, dipeptidyl peptidase IV inhibitors, glucagon-like peptide-1 receptor agonists, sodium dependent glucose transporter-2 inhibitors, sulfonylurea compounds or thiazolidinediones, preferably, the insulin comprises porcine insulin, human insulin or recombinant human insulin, preferably, the insulin analogues comprise insulin lispro, insulin aspart, insulin glargine or insulin deltoid, preferably, the glycosidase inhibitors comprise acarbose, voglibose or miglitol, preferably, the dipeptidyl peptidase IV inhibitor comprises sitagliptin, vildagliptin, saxagliptin, alogliptin, linagliptin, gemagliptin or tigliptin, preferably, the glucagon-like peptide-1 receptor agonist comprises exenatide, bei Lalu peptide, liraglutide, loxinaide, somalunin, abilutide or duloxetide, preferably, the sodium-dependent glucose transporter-2 inhibitor comprises canagliflozin, dapagliflozin, engagliflozin, exeagliflozin, lugliflozin or tolagliflozin, preferably, the sulfonylurea compound comprises glibenclamide, glimepiride, gliclazide, glipizide or gliquidone, preferably, the thiazolidinedione compound comprises rosiglitazone, troglitazone, cyclic glitazone or pioglitagliquidone.
9. Use of an oral composition according to any one of claims 1-3 for the preparation of a medicament for the treatment or prophylaxis of hyperglycemia, type 2 diabetes, type 1 diabetes, obesity, impaired glucose tolerance, hyperlipidemia, diabetes with non-alcoholic fatty liver, diabetic cardiovascular disease, cardiovascular disease or non-alcoholic fatty liver.
10. Use of a pharmaceutical formulation according to any one of claims 4-9 for the preparation of a medicament for the treatment or prophylaxis of hyperglycemia, type 2 diabetes, type 1 diabetes, obesity, impaired glucose tolerance, hyperlipidemia, diabetes with non-alcoholic fatty liver, diabetic cardiovascular disease, cardiovascular disease or non-alcoholic fatty liver.
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