US2004167178A1PendingUtilityA1

Combination of FBPase inhibitors and insulin sensitizers for the treatment of diabetes

Priority: Dec 24, 1998Filed: Feb 17, 2004Published: Aug 26, 2004
Est. expiryDec 24, 2018(expired)· nominal 20-yr term from priority
A61K 31/4439A61K 31/7056A61K 31/675A61K 31/426A61K 45/06A61K 31/7076A61K 31/522
62
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Claims

Abstract

Pharmaceutical compositions containing an FBPase inhibitor and an insulin sensitizer are provided as well as methods for treating diabetes and diseases responding to increased glycemic control, an improvement in insulin sensitivity, a reduction in insulin levels, or an enhancement of insulin secretion.

Claims

exact text as granted — not AI-modified
We claim:  
     
         1 . A pharmaceutical composition comprising a pharmaceutically effective amount of an insulin sensitizer agent and a pharmaceutically effective amount of an FBPase inhibitor, or prodrugs or salts thereof.  
     
     
         2 . The pharmaceutical composition of  claim 1  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         3 . The pharmaceutical composition of  claim 2  wherein said thiazolidinedione is selected from the group consisting of BRL 49653, troglitazone, pioglitazone, ciglitazone, WAY-120,744, englitazone, AD 5075, Gl-262570, SB219994, SB219993, and darglitazone.  
     
     
         4 . The pharmaceutical composition of  claim 1  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         5 . The pharmaceutical composition of  claim 4  wherein said PPARγ agonist is selected from the group consisting of BRL 49653, troglitazone, pioglitazone, ciglitazone, WAY-120,744, englitazone, AD 5075, darglitazone, Gl-262570, SB 217092, SB 236636, SB 217092, SB 219994, and SB 219993.  
     
     
         6 . The pharmaceutical composition of  claim 1  wherein said insulin sensitizer is a RXR ligand.  
     
     
         7 . The pharmaceutical composition of  claim 6  wherein said RXR ligand is selected from the group consisting of 9-cis retinoic acid, LG 100268 and LG 1069.  
     
     
         8 . The pharmaceutical composition of  claim 1  wherein said insulin sensitizer is selected from the group consisting of an angiotensin converting enzyme inhibitor, a renin inhibitor, and an angiotensin antagonist.  
     
     
         9 . The pharmaceutical composition of  claim 1  wherein said FBPase inhibitor is a compound selected from the group consisting of formulae I and IA:  
       
         
           
           
               
               
           
         
         wherein in vivo or in vitro compounds of formulae I and IA are converted to M-PO 3   2−  which inhibits FBPase and wherein  
         Y is independently selected from the group consisting of —O—, and NR 6 —;  
         when Y is —O—, then R 1  attached to —O— is independently selected from the group consisting of —H, alkyl, optionally substituted aryl, optionally substituted alicyclic where the cyclic moiety contains a carbonate or thiocarbonate, optionally substituted -alkylaryl, —C(R 2 ) 2 OC(O)NR 2   2 , —NR 2 —C(O)—R 3 , —C(R 2 ) 2 —OC(O)R 3 , —C(R 2 ) 2 —O—C(O)OR 2 , —C(R 2 ) 2 OC(O)SR 3 , -alkyl-S—C(O)R 3 , -alkyl-S—S-alkylhydroxy, and -alkyl-S—S—S-alkylhydroxy,  
         when Y is —NR 6 —, then R 1  attached to —NR 6 — is independently selected from the group consisting of —H, —[C(R 2 ) 2 ] q —COOR 3 , —C(R 4 ) 2 COOR 3 , —[C(R 2 ) 2 ] q —C(O)SR, and -cycloalkylene-COOR 3 ;  
         or when either Y is independently selected from —O— and —NR then together R 1  and R 1  are -alkyl-S—S-alkyl- to form a cyclic group, or together R 1  and R 1  are  
         
           
             
             
                 
                 
             
           
         
         wherein  
         V, W, and W′ are independently selected from the group consisting of —H, alkyl, aralkyl, alicyclic, aryl, substituted aryl, heteroaryl, substituted heteroaryl, 1-alkenyl, and 1-alkynyl; or  
         together V and Z are connected via an additional 3-5 atoms to form a cyclic group containing 5-7 atoms, optionally 1 heteroatom, substituted with hydroxy, acyloxy, alkoxycarbonyloxy, or aryloxycarbonyloxy attached to a carbon atom that is three atoms from both Y groups attached to the phosphorus; or  
         together V and Z are connected via an additional 3-5 atoms to form a cyclic group, optionally containing 1 heteroatom, that is fused to an aryl group at the beta and gamma position to the Y attached to the phosphorus;  
         together V and W are connected via an additional 3 carbon atoms to form an optionally substituted cyclic group containing 6 carbon atoms and substituted with one substituent selected from the group consisting of hydroxy, acyloxy, alkoxycarbonyloxy, alkylthiocarbonyloxy, and aryloxycarbonyloxy, attached to one of said carbon atoms that is three atoms from a Y attached to the phosphorus;  
         together Z and W are connected via an additional 3-5 atoms to form a cyclic group, optionally containing one heteroatom, and V must be aryl, substituted aryl, heteroaryl, or substituted heteroaryl;  
         together W and W′ are connected via an additional 2-5 atoms to form a cyclic group, optionally containing 0-2 heteroatoms, and V must be aryl, substituted aryl, heteroaryl, or substituted heteroaryl;  
         Z is selected from the group consisting of —CHR 2 OH, —CHR 2 OC(O)R 3 , —CHR 2 OC(S)R 3 , —CHR 2 OC(S)OR 3 , —CHR 2 OC(O)SR 3 , —CHR 2 OCO 2 R 3 , —OR 2 , —SR 2 —CHR 2 N 3 , —CH 2 aryl, —CH(aryl)OH, —CH(CH═CR 2   2 )OH, —CH(C═CR 2 )OH, —R 2  , —NR 2   2 , —OCOR 3 , —OCO 2 R 3 , —SCOR 3 , —SCO 2 R 3 , —NHCOR 2 , —NHCO 2 R 3 , —CH 2 NHaryl, —(CH 2 ) p —OR 2 , and —(CH 2 ) p —SR 2 ;  
         p is an integer 2 or 3;  
         q is an integer 1 or 2;  
         with the provisos that:  
         a) V, Z, W, W′ are not all —H; and  
         b) when Z is —R 2 , then at least one of V, W, and W′ is not —H, alkyl, aralkyl, or alicyclic;  
         R 2  is selected from the group consisting of R 3  and —H;  
         R 3  is selected from the group consisting of alkyl, aryl, alicyclic, and aralkyl;  
         each R 4  is independently selected from the group consisting of —H, and alkyl, or together R 4  and R 4  form a cyclic alkyl group;  
         R 6  is selected from the group consisting of —H, lower alkyl, acyloxyalkyl, alkoxycarbonyloxyalkyl, and lower acyl;  
         n is an integer from 1 to 3;  
         R 18  is independently selected from the group consisting of H, lower alkyl, aryl, aralkyl, or together with R 12  is connected via 1-4 carbon atoms to form a cyclic group;  
         each R 12  and R 13  is independently selected from the group consisting of H, lower alkyl, lower aryl, lower aralkyl, all optionally substituted, or R 12  and R 13  together are connected via 2-6 carbon atoms to form a cyclic group;  
         each R 14  is independently selected from the group consisting of —OR 17 , —N(R 17 ) 2 , —NHR 17 , and —SR 17 ;  
         R 15  is selected from the group consisting of —H, lower alkyl, lower aryl, lower arakyl, or together with R 16  is connected via 2-6 atoms, optionally including 1 heteroatom selected from the group consisting of O, N, and S;  
         R 16  is selected from the group consisting of —(CR 12 R 13 ) n —C(O)—R 14 , lower alkyl, lower aryl, lower aralkyl, or together with R 15  is connected via 2-6 atoms, optionally including 1 heteroatom selected from the group consisting of O, N, and S;  
         each R 17  is independently selected from the group consisting of lower alkyl, lower aryl, and lower aralkyl, or together R 17  and R 17  on N is connected via 2-6 atoms, optionally including 1 heteroatom selected from the group consisting of O, N, and S;  
         with the proviso that when only one Y is —O—, and it is not part of a cyclic group containing the other Y, then the other Y must be —N(R 18 )—(CR 12 R 13 )—C(O)—R 14 .  
         and pharmaceutically acceptable prodrugs and salts thereof.  
       
     
     
         10 . The pharmaceutical composition of  claim 9  wherein said M is:  
       
         
           
           
               
               
           
         
       
       wherein 
 Z′ is selected from the group consisting of alkyl or halogen,  
 U and V′ are independently selected from the group consisting of hydrogen, hydroxy, acyloxy or when taken together form a lower cyclic ring containing at least one oxygen;  
 W′ is selected from the group consisting of amino and lower alkyl amino;  
 and pharmaceutically acceptable salts thereof.  
 
     
     
         11 . The pharmaceutical composition of  claim 10  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         12 . The pharmaceutical composition of  claim 10  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         13 . The pharmaceutical composition of  claim 10  wherein said insulin sensitizer is a RXR ligand.  
     
     
         14 . The pharmaceutical composition of  claim 9  wherein M is:  
       
         
           
           
               
               
           
         
       
       wherein 
 A 2  is selected from the group consisting of —NR 8   2 , NHSO 2 R 3 , —OR 5 , —SR 5 , halogen, lower alkyl, —CON(R 4 ) 2 , guanidine, amidine, —H, and perhaloalkyl;  
 E 2  is selected from the group consisting of —H, halogen, lower alkylthio, lower perhaloalkyl, lower alkyl, lower alkenyl, lower alkynyl, lower alkoxy, —CN, and —NR 7   2 ;  
 X 3  is selected from the group consisting of -alkyl(hydroxy)-, -alkyl-, -alkynyl-, -aryl-, -carbonylalkyl-, -1,1-dihaloalkyl-, -alkoxyalkyl-, -alkyloxy-, -alkylthioalkyl-, -alkylthio-, -alkylaminocarbonyl-, -alkylcarbonylamino-, -alicyclic-, -aralkyl-, -alkylaryl-, -alkoxycarbonyl-, -carbonyloxyalkyl-, -alkoxycarbonylamino-, and -alkylaminocarbonylamino-, all optionally substituted; with the proviso that X 3  is not substituted with —COOR 2 , —SO 3 H, or —PO 3 R 2   2 ;  
 Y 3  is selected from the group consisting of —H, alkyl, alkenyl, alkynyl, aryl, alicyclic, aralkyl, aryloxyalkyl, alkoxyalkyl, —C(O)R 3 , —S(O) 2 R 3 , —C(O)—R 11 , —CONHR 3 , —NR 2   2 , and —OR 3 , all except H are optionally substituted;  
 each R 4  is independently selected from the group consisting of —H and alkyl, or together R 4  and R 4  form a cyclic alkyl group;  
 R 5  is selected from the group consisting of lower alkyl, lower aryl, lower aralkyl, and lower alicyclic;  
 R 7  is independently selected from the group consisting of —H, lower alkyl, lower alicyclic, lower aralkyl, lower aryl, and —C(O)R 10 ;  
 R 8  is independently selected from the group consisting of —H, lower alkyl, lower aralkyl, lower aryl, lower alicyclic, —C(O)R 10 , or together they form a bidendate alkyl;  
 R 10  is selected from the group consisting of —H, lower alkyl, —NH 2 , lower aryl, and lower perhaloalkyl; and  
 R 11  is selected from the group consisting of alkyl, aryl, —NR 2   2 , and —OR 2 , and pharmaceutically acceptable prodrugs and salts thereof.  
 pharmaceutically acceptable prodrugs and salts thereof  
 
     
     
         15 . The pharmaceutical composition of  claim 13  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         16 . The pharmaceutical composition of  claim 13  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         17 . The pharmaceutical composition of  claim 13  wherein said insulin sensitizer is a RXR ligand.  
     
     
         18 . The pharmaceutical composition of  claim 9  wherein M is:  
       
         
           
           
               
               
           
         
       
       wherein: 
 A, E, and L are selected from the group consisting of —NR 8   2 , —NO 2 , —H, —OR 7 , —SR 7 , —C(O)NR 4   2 , halo, —COR 11 , —SO 2 R 3 , guanidine, amidine, —NHSO 2 R 5 , —SO 2 NR 4   2 , —CN, sulfoxide, perhaloacyl, perhaloalkyl, perhaloalkoxy, C1-C5 alkyl, C2-C5 alkenyl, C2-C5 alkynyl, and lower alicyclic, or together A and L form a cyclic group, or together L and E form a cyclic group, or together E and J form a cyclic group including aryl, cyclic alkyl, and heterocyclic;  
 J is selected from the group consisting of —NR 8   2 , —NO 2 , —H, —OR 7 , —SR 7 , —C(O)NR 4   2 , halo, —C(O)R 11 , —CN, sulfonyl, sulfoxide, perhaloalkyl, hydroxyalkyl, perhaloalkoxy, alkyl, haloalkyl, aminoalkyl, alkenyl, alkynyl, alicyclic, aryl, and aralkyl, or together with Y forms a cyclic group including aryl, cyclic alkyl and heterocyclic alkyl;  
 X 3  is selected from the group consisting of -alkyl(hydroxy)-, -alkyl-, -alkynyl-, -aryl-, -carbonylalkyl-, -1,1-dihaloalkyl-, -alkoxyalkyl-, -alkyloxy-, -alkylthioalkyl-, -alkylthio-, -alkylaminocarbonyl-, -alkylcarbonylamino-, -alicyclic-, -aralkyl-, -alkylaryl-, -alkoxycarbonyl-, -carbonyloxyalkyl-, -alkoxycarbonylamino-, and -alkylaminocarbonylamino-, all optionally substituted; with the proviso that X 3  is not substituted with —COOR 2 , —SO 3 H, or —PO 3 R 2   2 ;  
 Y 3  is selected from the group consisting of —H, alkyl, alkenyl, alkynyl, aryl, alicyclic, aralkyl, aryloxyalkyl, alkoxyalkyl, —C(O)R 3 , —S(O) 2 R 3 , —C(O)—R 11 , —CONHR 3 , —NR 2   2 , and —OR 3 , all except H are optionally substituted;  
 R 4  is independently selected from the group consisting of —H and alkyl, or together R 4  and R 4  form a cyclic alkyl group;  
 R 5  is selected from the group consisting of lower alkyl, lower aryl, lower aralkyl, and lower alicyclic;  
 R 7  is independently selected from the group consisting of —H, lower alkyl, lower alicyclic, lower aralkyl, lower aryl, and —C(O)R 10 ;  
 R 8  is independently selected from the group consisting of —H, lower alkyl, lower aralkyl, lower aryl, lower alicyclic, —C(O)R 10 , or together they form a bidendate alkyl;  
 R 10  is selected from the group consisting of —H, lower alkyl, —NH 2 , lower aryl, and lower perhaloalkyl;  
 R 11  is selected from the group consisting of alkyl, aryl, —NR 2   2 , and —OR 2 , and  
 pharmaceutically acceptable prodrugs and salts thereof.  
 
     
     
         19 . The pharmaceutical composition of  claim 18  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         20 . The pharmaceutical composition of  claim 18  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         21 . The pharmaceutical composition of  claim 18  wherein said insulin sensitizer is a RXR ligand.  
     
     
         22 . The pharmaceutical composition of  claim 9  wherein M is:  
       
         
           
           
               
               
           
         
       
       wherein: 
 B is selected from the group consisting of —NH—, —N═ and —CH═;  
 D is selected from the group consisting of  
                     
 Q is selected from the group consisting of —C═ and —N— with the proviso that when B is —NH— then Q is —C═ and D is  
                     
 when B is —CH═ then Q is —N— and D is  
                     
 when B is —N═, then D is  
                     
 and Q is —C═;  
 A, E, and L are selected from the group consisting of —NR 8   2 , —NO 2 , —H, —OR 7 , —SR 7 , —C(O)NR 4   2 , halo, —COR 11 , —SO 2 R 3 , guanidine, amidine, —NHSO 2 R 5 , —SO 2 NR 4   2 , —CN, sulfoxide, perhaloacyl, perhaloalkyl, perhaloalkoxy, C1-C5 alkyl, C2-C5 alkenyl, C2-C5 alkynyl, and lower alicyclic, or together A and L form a cyclic group, or together L and E form a cyclic group, or together E and J form a cyclic group including aryl, cyclic alkyl, and heterocyclic;  
 J is selected from the group consisting of —NR 8   2 , —NO 2 , —H, —OR 7 , —SR 7 , —C(O)NR 4   2 , halo, —C(O)R 11 , —CN, sulfonyl, sulfoxide, perhaloalkyl, hydroxyalkyl, perhaloalkoxy, alkyl, haloalkyl, aminoalkyl, alkenyl, alkynyl, alicyclic, aryl, and aralkyl, or together with Y forms a cyclic group including aryl, cyclic alkyl and heterocyclic alkyl;  
 X 3  is selected from the group consisting of -alkyl(hydroxy)-, -alkyl-, -alkynyl-, -aryl-, -carbonylalkyl-, -1,1-dihaloalkyl-, -alkoxyalkyl-, -alkyloxy-, -alkylthioalkyl-, -alkylthio-, -alkylaminocarbonyl-, -alkylcarbonylamino-, -alicyclic-, -aralkyl-, -alkylaryl-, -alkoxycarbonyl-, -carbonyloxyalkyl-, -alkoxycarbonylamino-, and -alkylaminocarbonylamino-, all optionally substituted; with the proviso that X 3  is not substituted with —COOR 2 , —SO 3 H, or —PO 3 R 2   2 ;  
 Y 3  is selected from the group consisting of —H, alkyl, alkenyl, alkynyl, aryl, alicyclic, aralkyl, aryloxyalkyl, alkoxyalkyl, —C(O)R 3 , —S(O) 2 R 3 , —C(O)—R 11 , —CONHR 3 , —NR 2   2 , and —OR 3 , all except H are optionally substituted;  
 R 4  is independently selected from the group consisting of —H and alkyl, or together R 4  and R 4  form a cyclic alkyl group;  
 R 5  is selected from the group consisting of lower alkyl, lower aryl, lower aralkyl, and lower alicyclic;  
 R 7  is independently selected from the group consisting of —H, lower alkyl, lower alicyclic, lower aralkyl, lower aryl, and —C(O)R 10 ;  
 R 8  is independently selected from the group consisting of —H, lower alkyl, lower aralkyl, lower aryl, lower alicyclic, —C(O)R 10 , or together they form a bidentate alkyl;  
 R 10  is selected from the group consisting of —H, lower alkyl, —NH 2 , lower aryl, and lower perhaloalkyl;  
 R 11  is selected from the group consisting of alkyl, aryl, —NR 2   2  and —OR 3 ; and  
 pharmaceutically acceptable prodrugs and salts thereof.  
 
     
     
         23 . The pharmaceutical composition of  claim 22  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         24 . The pharmaceutical composition of  claim 22  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         25 . The pharmaceutical composition of  claim 22  wherein said insulin sensitizer is a RXR ligand.  
     
     
         26 . The pharmaceutical composition of  claim 9  wherein M is R 5 —X—: 
 wherein R 5  is selected from the group consisting of:  
                     
 wherein:  
 each G is independently selected from the group consisting of C, N, O, S, and Se, and wherein only one G may be O, S, or Se, and at most one G is N;  
 each G′ is independently selected from the group consisting of C and N and wherein no more than two G′ groups are N;  
 A is selected from the group consisting of —H, —NR 4   2 , —CONR 4   2 , —CO 2 R 3 , halo, —S(O)R 3 , —SO 2 R 3 , alkyl, alkenyl, alkynyl, perhaloalkyl, haloalkyl, aryl, —CH 2 OH, —CH 2 NR 4   2 , —CH 2 CN, —CN, —C(S)NH 2 , —OR 3 , —SR 3 , —N 3 , —NHC(S)NR 4   2 , —NHAc, and null;  
 each B and D are independently selected from the group consisting of —H, alkyl, alkenyl, alkynyl, aryl, alicyclic, aralkyl, alkoxyalkyl, —C(O)R 11 , —C(O)SR 3 , —SO 2 R 11 , —S(O)R 3 , —CN, —NR 9   2 , —OR 3 , —SR 3 , perhaloalkyl, halo, —NO 2 , and null, all except —H, —CN, perhaloalkyl, —NO 2 , and halo are optionally substituted;  
 E is selected from the group consisting of —H, alkyl, alkenyl, alkynyl, aryl, alicyclic, alkoxyalkyl, —C(O)OR 3 , —CONR 4   2 , —CN, —NR 12 , —NO 2 , —OR 3 , —SR 3 , perhaloalkyl, halo, and null, all except —H, —CN, perhaloalkyl, and halo are optionally substituted;  
 J is selected from the group consisting of —H and null;  
 X is an optionally substituted linking group that links R 5  to the phosphorus atom via 2-4 atoms, including 0-1 heteroatoms selected from N, 0, and S, except that if X is urea or carbamate there is 2 heteroatoms, measured by the shortest path between R 5  and the phosphorus atom, and wherein the atom attached to the phosphorus is a carbon atom, and wherein X is selected from the group consisting of -alkyl(hydroxy)-, -alkynyl-, -heteroaryl-, -carbonylalkyl-, -1,1-dihaloalkyl-, -alkoxyalkyl-, -alkyloxy-, -alkylthioalkyl-, -alkylthio-, -alkylaminocarbonyl-, -alkylcarbonylamino-, -alkoxycarbonyl-, -carbonyloxyalkyl-, -alkoxycarbonylamino-, and -alkylaminocarbonylamino-, all optionally substituted; with the proviso that X is not substituted with —COOR 2 , —SO 3 H, or —PO 3 R 2   2 ;  
 R 2  is selected from the group consisting of R 3  and —H;  
 R 3  is selected from the group consisting of alkyl, aryl, alicyclic, and aralkyl;  
 each R 4  is independently selected from the group consisting of —H, and alkyl, or together R 4  and R 4  form a cyclic alkyl group;  
 each R 9  is independently selected from the group consisting of —H, alkyl, aralkyl, and alicyclic, or together R 9  and R 9  form a cyclic alkyl group;  
 R 11  is selected from the group consisting of alkyl, aryl, —NR 2   2 , and —OR 2 ;  
 and with the proviso that:  
 1) when G′ is N, then the respective A, B, D, or E is null;  
 2) at least one of A and B, or A, B, D, and E is not selected from the group consisting of —H or null;  
 3) when R 5  is a six-membered ring, then X is not any 2 atom linker, an optionally substituted -alkyloxy-, or an optionally substituted -alkylthio-;  
 4) when G is N, then the respective A or B is not halogen or a group directly bonded to G via a heteroatom;  
 5) when X is not a -heteroaryl- group, then R 5  is not substituted with two or more aryl groups;  
 and pharmaceutically acceptable prodrugs and salts thereof.  
 
     
     
         27 . The compounds of  claim 26  wherein when R 5  is 2-thiazolyl, 2-oxazolyl, or 2-selenazolyl, and X is -alkoxyalkyl-, -alkylthioalkyl-, -alkyloxy-, or -alkylthio-, then A is not —CONH 2  and B is not —H.  
     
     
         28 . The compounds of  claim 26  wherein when R 5  is 2-thiazolyl, 2-oxazolyl, or 2-selenazolyl, then X is not -alkyloxyalkyl-, -alkylthioalkyl-, -alkyloxy-, or -alkylthio-.  
     
     
         29 . The compounds of  claim 27  wherein said compound of formula I or formula IA has an IC 50  of ≦50 μM on glucose production in isolated rat hepatocytes.  
     
     
         30 . The compounds of  claim 29  wherein R 5  is selected from the group consisting of pyrrolyl, imidazolyl, oxazolyl, thiazolyl, isothiazolyl, 1,2,4-thiadiazolyl, pyrazolyl, isoxazolyl, 1,2,3-oxadiazolyl, 1,2,4-oxadiazolyl, 1,2,5-oxadiazolyl, 1,3,4-oxadiazolyl, 1,2,4-thiadiazolyl, 1,3,4-thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, 1,3,5-triazinyl, 1,2,4-triazinyl, and 1,3-selenazolyl, all of which contain at least one substituent.  
     
     
         31 . The compounds of  claim 30  wherein R 5  is not 2-thiazolyl, or 2-oxazolyl.  
     
     
         32 . The compounds of  claim 31  wherein 
 A is selected from the group consisting of —H, —NR 4   2 , —CONR 4   2 , —CO 2 R 3 , halo, C1-C6 alkyl, C2-C6 alkenyl, C2-C6 alkynyl, C1-C6 perhaloalkyl, C1-C6 haloalkyl, aryl, —CH 2 OH, —CH 2 NR 4   2 , —CH 2 CN, —CN, —C(S)NH 2 , —OR 4 , —SR 4 , —N 3 , —NHC(S)NR 4   2 , —NHAc, and null;  
 each B and D are independently selected from the group consisting of —H, alkyl, alkenyl, alkynyl, aryl, alicyclic, aralkyl, alkoxyalkyl, —C(O)R 11 , —C(O)SR 3 , —SO 2 R 11 , —S(O)R 3 , —CN, —NR 2   2 , —OR 3 , —SR 3 , perhaloalkyl, halo, and null, all except —H, —CN, perhaloalkyl, and halo are optionally substituted;  
 E is selected from the group consisting of —H, C1-C6 alkyl, C2-C6 alkenyl, C2-C6 alkynyl, aryl, C4-C6 alicyclic, alkoxyalkyl, —C(O)OR 3 , —CONR 4   2 , —CN, —NR 12 , —OR 3 , —SR 3 , C1-C6 perhaloalkyl, halo, and null, all except —H, —CN, perhaloalkyl, and halo are optionally substituted; and  
 each R 4  is independently selected from the group consisting of —H, and C1-C 2  alkyl.  
 
     
     
         33 . The compounds of  claim 31  wherein R 5  is:  
       
         
           
           
               
               
           
         
       
     
     
         34 . The compounds of  claim 31  wherein R 5  is:  
       
         
           
           
               
               
           
         
       
     
     
         35 . The compounds of  claim 31  wherein R 5  is selected from the group consisting of:  
       
         
           
           
               
               
           
         
       
       wherein 
 A″ is selected from the group consisting of —H, —NR 4   2 ,—CONR 4   2 , —CO 2 R 3 , halo, C1-C6 alkyl, C2-C6 alkenyl, C2-C6 alkynyl, C1-C6 perhaloalkyl, C1-C6 haloalkyl, aryl, —CH 2 OH, —CH 2 NR 4   2 , —CH 2 CN, —CN, —C(S)NH 2 , —OR 3 , —SR 3 , —N 3 , —NHC(S)NR 4   2 , and —NHAc;  
 B″ and D″ are independently selected from the group consisting of —H, alkyl, alkenyl, alkynyl, aryl, alicyclic, aralkyl, alkoxyalkyl, —C(O)R 11 , —C(O)SR 3 , —SO 2 R 11 , —S(O)R 3 , —CN, —NR 9   2 , —OR 3 , —SR 3 , perhaloalkyl, and halo, all except —H, —CN, perhaloalkyl, and halo are optionally substituted;  
 E″ is selected from the group consisting of —H, C1-C6 alkyl, C2-C6 alkenyl, C2-C6 alkynyl, C4-C6 alicychic, alkoxyalkyl, —C(O)OR 3 , —CONR 2 , —CN, —NR 9   2 , —OR 3 , —SR 3 , C1-C 6  perhaloalkyl, and halo, all except H, —CN, perhaloalkyl, and halo are optionally substituted; and  
 each R 4  is independently selected from the group consisting of —H and C1-C2 alkyl.  
 
     
     
         36 . The compounds of  claim 35  wherein R 5  is selected from the group consisting of:  
       
         
           
           
               
               
           
         
       
     
     
         37 . The compounds of  claim 35  wherein R 5  is selected from the group consisting of:  
       
         
           
           
               
               
           
         
       
     
     
         38 . The compounds of  claim 35  wherein R 5  is selected from the group consisting of:  
       
         
           
           
               
               
           
         
       
     
     
         39 . The compounds of  claim 32  wherein X is selected from the group consisting of -heteroaryl-, -alkylcarbonylamino-, -alkylaminocarbonyl-, and -alkoxycarbonyl-.  
     
     
         40 . The compounds of  claim 39  wherein X is selected from the group consisting of -heteroaryl-, and -alkoxycarbonyl-.  
     
     
         41 . The compounds of  claim 32  wherein said compound is a compound of formulae VII, VIII, or IX:  
       
         
           
           
               
               
           
         
       
     
     
         42 . The compounds of  claim 35  wherein X is selected from the group consisting of -heteroaryl-, -alkylcarbonylamino-, -alkylaminocarbonyl-, and -alkoxycarbonyl-.  
     
     
         43 . The compounds of  claim 41  wherein said compound is a compound of formulae VII or IX:  
       
         
           
           
               
               
           
         
       
     
     
         44 . The compounds of  claim 42  wherein A″ is selected from the group consisting of —NH 2 , —CONH 2 , halo, —CH 3 , —CF 3 , —CH 2 -halo, —CN, —OCH 3 , —SCH 3 , and —H.  
     
     
         45 . The compounds of  claim 44  wherein A″ is selected from the group consisting of —NH 2 , —Cl, —Br, and —CH 3 .  
     
     
         46 . The compounds of  claim 42  wherein each B″ is selected from the group consisting of —H, —C(O)R 11 , —C(O)SR 3 , alkyl, aryl, alicyclic, halo, —CN, —SR 3 , —NR 9   2 , and —OR 3 .  
     
     
         47 . The compounds of  claim 46  wherein each B″ is selected from the group consisting of —H, —C(O)OR 3 , —C(O)SR 3 , C1-C6 alkyl, alicyclic, halo, heteroaryl, and —SR 3 .  
     
     
         48 . The compounds of  claim 42  wherein D″ is selected from the group consisting of —H, —C(O)R 11 , —C(O)SR 3 , alkyl, aryl, alicyclic, halo, —NR 9   2 , and —SR 3 .  
     
     
         49 . The compounds of  claim 48  wherein D″ is selected from the group consisting of —H, —C(O)OR 3 , lower alkyl, alicyclic, and halo.  
     
     
         50 . The compounds of  claim 42  wherein E″ is selected from the group consisting of —H, C1-C6 alkyl, lower alicyclic, halogen, —CN, —C(O)OR 3 , —SR 3 , and —CONR 4   2 .  
     
     
         51 . The compounds of  claim 50  wherein E″ is selected from the group consisting of —H, —Br, and —Cl.  
     
     
         52 . The compounds of  claim 31  wherein R 18  is selected from the group consisting of —H, methyl, and ethyl.  
     
     
         53 . The compounds of  claim 52  wherein R 18  is selected from the group consisting of —H and methyl.  
     
     
         54 . The compounds of  claim 53  wherein R 18  is —H.  
     
     
         55 . The compounds of  claim 31  wherein each R 12  and R 13  is independently selected from the group consisting of —H, methyl, ethyl, n-propyl, i-propyl, n-butyl, i-butyl, —CH 2 CH 2 —SCH 3 , phenyl, and benzyl, or together R 12  and R 13  are connected via 2-5 carbon atoms to form a cycloalkyl group.  
     
     
         56 . The compounds of  claim 55  wherein each R 12  and R 13  is independently selected from the group consisting of —H, methyl, i-propyl, i-butyl, and benzyl, or together R 12  and R 13  are connected via 2-5 carbon atoms to form a cycloalkyl group.  
     
     
         57 . The compounds of  claim 56  wherein each R 12  and R 13  is independently selected from the group consisting of —H, methyl, i-propyl, and benzyl, or together R 12  and R 13  are connected via 4 carbon atoms to form a cyclopentyl group.  
     
     
         58 . The compounds of  claim 57  wherein R 12  and R 13  are both —H, both methyl, or R 12  is H and R 13  is selected from the group consisting of methyl, i-propyl, and benzyl.  
     
     
         59 . The compounds of  claim 58  wherein n is 1, and R 12  is —H, then the carbon attached to R 12  and R 13  has S stereochemistry.  
     
     
         60 . The compounds of  claim 31  wherein n is an integer of from 1-2.  
     
     
         61 . The compounds of  claim 60  wherein n is 1.  
     
     
         62 . The compounds of  claim 31  wherein each R 14  is independently selected from the group consisting of —OR 17 , and —SR 17 ; and R 17  is selected from the group consisting of optionally substituted methyl, ethyl, propyl, t-butyl, and benzyl.  
     
     
         63 . The compounds of  claim 62  wherein each R 14  is independently selected from the group consisting of —OR 17 ; and R 17  is selected from the group consisting of methyl, ethyl, propyl, and benzyl.  
     
     
         64 . The compounds of  claim 63  wherein R 17  is selected from the group consisting of ethyl, and benzyl.  
     
     
         65 . The compounds of  claim 31  wherein R 15  is not H.  
     
     
         66 . The compounds of  claim 65  wherein R 15  and R 16  are independently selected from the group consisting of lower alkyl, and lower aralkyl, or together R 15  and R 16  are connected via 2-6 atoms, optionally including 1 heteroatom selected from the group consisting of O, N, and S.  
     
     
         67 . The compounds of  claim 66  wherein R 15  and R 16  are independently selected from the group consisting of C1-C6 alkyl, or together R 15  and R 16  are connected via 2-6 atoms, optionally including 1 heteroatom selected from the group consisting of O, N, and S.  
     
     
         68 . The compounds of  claim 67  wherein —NR 15 R 16  is a cyclic amine.  
     
     
         69 . The compounds of  claim 68  wherein —NR 15 R 16  is selected from the group consisting of morpholinyl and pyrrolidinyl.  
     
     
         70 . The compounds of  claim 31  wherein R 16  is —(CR 12 R 13 ) n —C(O)—R 14 .  
     
     
         71 . The compounds of  claim 61  wherein 
 R 18  is selected from the group consisting of —H, methyl, and ethyl;  
 R 12  and R 13  are independently selected from the group consisting of —H, methyl, i-propyl, i-butyl, and benzyl, or together are connected via 2-5 carbon atoms to form a cycloalkyl group;  
 R 14  is —OR 17 ;  
 R 17  is selected from the group consisting of methyl, ethyl, propyl, t-butyl, and benzyl; and  
 R 15  and R 16  are independently selected from the group consisting of lower alkyl, and lower aralkyl, or together R 15  and R 16  are connected via 2-6 atoms, optionally including 1 heteroatom selected from the group consisting of O, and N.  
 
     
     
         72 . The compounds of  claim 70  that are of the formula:  
       
         
           
           
               
               
           
         
       
     
     
         73 . The compounds of  claim 72  wherein n is 1.  
     
     
         74 . The compounds of  claim 73  wherein when R 12  R 13  are not the same, then H 2 N—CR 12 R 13 —C(O)—R 14  is an ester, or thioester of a naturally occurring amino acid; and R 14  is selected from the group consisting of —OR 17  and ‘SR 17 .  
     
     
         75 . The compounds of  claim 35  wherein 
 A″ is selected from the group consisting of —NH 2 , —CONH 2 , halo, —CH 3 , —CF 3 , —CH 2 -halo, —CN, —OCH 3 , —SCH 3 , and —H;  
 B″ is selected from the group consisting of —H, —C(O)R 11 , —C(O)SR 3 , alkyl, aryl, alicyclic, halo, —CN, —SR 3 , OR 3  and —NR 9   2 ;  
 D″ is selected from the group consisting of —H, —C(O)R 11 , —C(O)SR 3 , —NR 9   2 , alkyl, aryl, alicyclic, halo, and —SR 3 ;  
 E″ is selected from the group consisting of —H, C1-C6 alkyl, lower alicyclic, halo, —CN, —C(O)OR 3 , and —SR 3 .  
 X is selected from the group consisting of -heteroaryl-, -alkoxycarbonyl-, and -alkylaminocarbonyl-, all optionally substituted;  
 R 18  and R 15  are selected from the group consisting of H, and methyl;  
 R 2  is selected from the group consisting of R 3  and —H;  
 R 3  is selected from the group consisting of alkyl, aryl, alicyclic, and aralkyl;  
 each R 12  and R 13  is independently selected from the group consisting of —H, methyl, i-propyl, i-butyl, and benzyl, or together R 12  and R 13  are connected via 2-5 carbon atoms to form a cycloalkyl group;  
 n is 1;  
 R 14  is —OR 17 ;  
 R 16  is —(CR 12 R 13 ) n —C(O)—R 14 ; and  
 R 17  is selected from the group consisting of methyl, ethyl, propyl, phenyl, and benzyl.  
 
     
     
         76 . The compounds of  claim 75  wherein  
       
         
           
           
               
               
           
         
       
       is selected from the group consisting of  
       
         
           
           
               
               
           
         
         wherein C* has S stereochemistry.  
       
     
     
         77 . The compounds of  claim 75  wherein R 5  is  
       
         
           
           
               
               
           
         
         X is selected from the group consisting of methylenoxycarbonyl, and furan-2,5-diyl, and pharmaceutically acceptable salts thereof.  
       
     
     
         78 . The compounds of  claim 77  wherein A″ is —NH 2 , X is furan-2,5-diyl, and B″ is —S(CH 2 ) 2 CH 3 .  
     
     
         79 . The compounds of  claim 77  wherein A″ is —NH 2 , X is furan-2,5-diyl, and B″ is —CH 2 —CH(CH 3 ) 2 .  
     
     
         80 . The compounds of  claim 77  wherein A″ is —NH 2 , X is furan-2,5-diyl, and B″ is —COOEt.  
     
     
         81 . The compounds of  claim 77  wherein A″ is —NH 2 , X is furan-2,5-diyl, and B″ is —SMe.  
     
     
         82 . The compounds of  claim 77  wherein A″ is —NH 2 , X is methyleneoxycarbonyl, and B″ is —CH(CH 3 ) 2 .  
     
     
         83 . The compounds of  claim 78  wherein  
       
         
           
           
               
               
           
         
       
     
     
         84 . The compounds of  claim 78  wherein  
       
         
           
           
               
               
           
         
       
       wherein C* has S stereochemistry.  
     
     
         85 . The compounds of  claim 78  wherein  
       
         
           
           
               
               
           
         
       
     
     
         86 . The compounds of  claim 78  wherein  
       
         
           
           
               
               
           
         
       
       wherein C* has S stereochemistry.  
     
     
         87 . The compounds of  claim 75  wherein R 5  is  
       
         
           
           
               
               
           
         
         X is selected from the group consisting of furan-2,5-diyl, and methyleneoxycarbonyl, A″ is —NH 2 , and pharmaceutically acceptable salts thereof.  
       
     
     
         88 . The compounds of  claim 87  wherein X is furan-2,5-diyl, and B″ is —SCH 2 CH 2 CH 3 .  
     
     
         89 . The compounds of  claim 75  wherein R 5  is  
       
         
           
           
               
               
           
         
         A″ is —NH 2 , E″ and D″ are —H, B″ is selected from the group consisting of cyclopropyl, and n-propyl, X is selected from the group consisting of methyleneoxycarbonyl, and furan-2,5-diyl, and pharmaceutically acceptable salts thereof.  
       
     
     
         90 . The compounds of  claim 75  wherein R 5  is  
       
         
           
           
               
               
           
         
         A″ is —NH 2 , D″ is —H, B″ is selected from the group consisting of n-propyl, and cyclopropyl, X is selected from the group consisting of furan-2,5-diyl, and methyleneoxycarbonyl, and pharmaceutically acceptable salts thereof.  
       
     
     
         91 . The pharmaceutical composition of  claim 26  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         92 . The pharmaceutical composition of  claim 26  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         93 . The pharmaceutical composition of  claim 26  wherein said insulin sensitizer is a RXR ligand.  
     
     
         94 . The pharmaceutical composition of  claim 1  wherein said combination is administered orally.  
     
     
         95 . A method of treating a mammal having diabetes comprising the administration to said mammal a pharmaceutically effective amount of an insulin sensitizer agent and a pharmaceutically effective amount of an FBPase inhibitor or prodrug or salt thereof.  
     
     
         96 . The method of  claim 95  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         97 . The method of  claim 96  wherein said thiazolidinedione is selected from the group consisting of BRL 49653, troglitazone, pioglitazone, ciglitazone, WAY-120,744, englitazone, AD 5075, GI-262570, SB219994, SB219993, and darglitazone.  
     
     
         98 . The method of  claim 95  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         99 . The method of  claim 98  wherein said PPARγ agonist is selected from the group consisting of BRL 49653, troglitazone, pioglitazone, ciglitazone, WAY-120,744, englitazone, AD 5075, darglitazone, Gl-262570, SB 217092, SB 236636, SB 217092, SB 219994 and SB 219993.  
     
     
         100 . The method of  claim 95  wherein said insulin sensitizer is a RXR ligand.  
     
     
         101 . The method of  claim 100  wherein said RXR ligand is selected from the group consisting of 9-cis retinoic acid, LG 100268 and LG 1069.  
     
     
         102 . The method of  claim 95  wherein said insulin sensitizer is selected from the group consisting of an angiotensin converting enzyme inhibitor, a renin inhibitor, and an angiotensin antagonist.  
     
     
         103 . The method of  claim 95  wherein said FBPase inhibitor is a compound of  claim 9 .  
     
     
         104 . The method of  claim 103  wherein M is:  
       
         
           
           
               
               
           
         
       
       wherein 
 Z′ is selected from the group consisting of alkyl or halogen,  
 U and V′ are independently selected from the group consisting of hydrogen, hydroxy, acyloxy or when taken together form a lower cyclic ring containing at least one oxygen;  
 W′ is selected from the group consisting of amino and lower alkyl amino;  
 and pharmaceutically acceptable salts thereof.  
 
     
     
         105 . The method of  claim 104  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         106 . The method of  claim 104  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         107 . The method of  claim 104  wherein said insulin sensitizer is a RXR ligand.  
     
     
         108 . The method of  claim 103  wherein M is:  
       
         
           
           
               
               
           
         
       
       wherein 
 A 2  is selected from the group consisting of —NR 8   2 , NHSO 2 R 3 , —OR 5 , —SR 5 , halogen, lower alkyl, —CON(R 4 ) 2 , guanidine, amidine, —H, and perhaloalkyl;  
 E 2  is selected from the group consisting of —H, halogen, lower alkylthio, lower perhaloalkyl, lower alkyl, lower alkenyl, lower alkynyl, lower alkoxy, —CN, and —NR 7   2 ;  
 X 3  is selected from the group consisting of -alkyl(hydroxy)-, -alkyl-, -alkynyl-, -aryl-, -carbonylalkyl-, -1,1-dihaloalkyl-, -alkoxyalkyl-, -alkyloxy-, -alkylthioalkyl-, -alkylthio-, -alkylaminocarbonyl-, -alkylcarbonylamino-, -alicyclic-, -aralkyl-, -alkylaryl-, -alkoxycarbonyl-, -carbonyloxyalkyl-, -alkoxycarbonylamino-, and -alkylaminocarbonylamino-, all optionally substituted; with the proviso that X 3  is not substituted with —COOR 2 , —SO 3 H, or —PO 3 R 2   2 ;  
 Y 3  is selected from the group consisting of —H, alkyl, alkenyl, alkynyl, aryl, alicyclic, aralkyl, aryloxyalkyl, alkoxyalkyl, —C(O)R 3 , —S(O) 2 R 3 , —C(O)—R 11 , —CONHR 3 , —NR 2   2 , and —OR 3 , all except H are optionally substituted;  
 each R 4  is independently selected from the group consisting of —H, and alkyl, or together R 4  and R 4  form a cyclic alkyl group;  
 R 5  is selected from the group consisting of lower alkyl, lower aryl, lower aralkyl, and lower alicyclic;  
 R 7  is independently selected from the group consisting of —H, lower alkyl, lower alicyclic, lower aralkyl, lower aryl, and —C(O)R 10 ;  
 R 8  is independently selected from the group consisting of —H, lower alkyl, lower aralkyl, lower aryl, lower alicyclic, —C(O)R 10 , or together they form a bidendate alkyl;  
 R 10  is selected from the group consisting of —H, lower alkyl; —NH 2,  lower aryl, and lower perhaloalkyl;  
 R 11  is selected from the group consisting of alkyl, aryl, —NR 2   2 , and —OR 2 , and  
 pharmaceutically acceptable prodrugs and salts thereof.  
 
     
     
         109 . The method of  claim 108  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         110 . The method of  claim 108  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         111 . The method of  claim 108  wherein said insulin sensitizer is a RXR ligand.  
     
     
         112 . The method of  claim 103  wherein M is:  
       
         
           
           
               
               
           
         
       
       wherein: 
 A, E, and L are selected from the group consisting of —NR 8   2 , —NO 2 , —H, —OR 7 , —SR 7 , —C(O)NR 4   2 , halo, —COR 11 , —SO 2 R 3 , guanidine, amidine, —NH SO 2 R 5 , —SO 2 NR 4   2 , —CN, sulfoxide, perhaloacyl, perhaloalkyl, perhaloalkoxy, C1-C5 alkyl, C2-C5 alkenyl, C2-C5 alkynyl, and lower alicyclic, or together A and L form a cyclic group, or together L and E form a cyclic group, or together E and J form a cyclic group including aryl, cyclic alkyl, and heterocyclic;  
 J is selected from the group consisting of —NR 8   2 , —NO 2 , —H, —OR 7 , —SR 7 , —C(O)NR 4   2 , halo, —C(O)R 11 , —CN, sulfonyl, sulfoxide, perhaloalkyl, hydroxyalkyl, perhaloalkoxy, alkyl, haloalkyl, aminoalkyl, alkenyl, alkynyl, alicyclic, aryl, and aralkyl, or together with Y forms a cyclic group including aryl, cyclic alkyl and heterocyclic alkyl;  
 X 3  is selected from the group consisting of -alkyl(hyoloxy)-, -alkyl-, -alkynyl-, -aryl-, -carbonylalkyl-, -1,1-dihaloalkyl-, -alkoxyalkyl-, -alkyloxy-, -alkylthioalkyl-, -alkylthio-, -alkylaminocarbonyl-, -alkylcarbonylamino-, -alicyclic-, -aralkyl-, -alkylaryl-, -alkoxycarbonyl-, -carbonyloxyalkyl-, -alkoxycarbonylamino-, and -alkylaminocarbonylamino-, all optionally substituted; with the proviso that X 3  is not substituted with —COOR 2 , —SO 3 H, or —PO 3 R 2   2 ;  
 Y 3  is selected from the group consisting of —H, alkyl, alkenyl, alkynyl, aryl, alicyclic, aralkyl, aryloxyalkyl, alkoxyalkyl, —C(O)R 3 , —S(O) 2 R 3 , —C(O)—R 11 , —CONHR 3 , —NR 2   2 , and —OR 3 , all except H are optionally substituted;  
 each R 4  is independently selected from the group consisting of —H, and alkyl, or together R 4  and R 4  form a cyclic alkyl group;  
 R 5  is selected from the group consisting of lower alkyl, lower aryl, lower aralkyl, and lower alicyclic;  
 R 7  is independently selected from the group consisting of —H, lower alkyl, lower alicyclic, lower aralkyl, lower aryl, and —C(O)R 10 ;  
 R 8  is independently selected from the group consisting of —H, lower alkyl, lower aralkyl, lower aryl, lower alicyclic, —C(O)R 10 , or together they form a bidendate alkyl;  
 R 10  is selected from the group consisting of —H, lower alkyl, —NH 2 , lower aryl, and lower perhaloalkyl;  
 R 11  is selected from the group consisting of alkyl, aryl, —NR 2   2 , and —OR 2 , and  
 pharmaceutically acceptable prodrugs and salts thereof.  
 
     
     
         113 . The method of  claim 112  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         114 . The method of  claim 112  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         115 . The method of  claim 112  wherein said insulin sensitizer is a RXR ligand.  
     
     
         116 . The method of  claim 103  wherein M is:  
       
         
           
           
               
               
           
         
       
       wherein: 
 B is selected from the group consisting of —NH—, —N═ and —CH═;  
 D is selected from the group consisting of  
                     
 Q is selected from the group consisting of —C═ and —N— with the proviso that when B is —NH— then Q is —C═ and D is  
                     
 when B is —CH═ then Q is —N— and D is  
                     
 when B is —N═, then D is  
                     
 and Q is —C═;  
 A, E, and L are selected from the group consisting of —NR 8   2 , —NO 2 , —H, —OR 7 , —SR 7 , —C(O)NR 4   2 , halo, —COR 11 , —SO 2 R 3 , guanidine, amidine, —NHSO 2 R 5 , —SO 2 NR 4   2 , —CN, sulfoxide, perhaloacyl, perhaloalkyl, perhaloalkoxy, C1-C5 alkyl, C2-C5 alkenyl, C2-C5 alkynyl, and lower alicyclic, or together A and L form a cyclic group, or together L and E form a cyclic group, or together E and J form a cyclic group including aryl, cyclic alkyl, and heterocyclic;  
 J is selected from the group consisting of —NR 8   2 , —NO 2 , —H, —OR 7 , —SR 7 , —C(O)NR 4   2 , halo, —C(O)R 11 , —CN, sulfonyl, sulfoxide, perhaloalkyl, hydroxyalkyl, perhaloalkoxy, alkyl, haloalkyl, aminoalkyl, alkenyl, alkynyl, alicyclic, aryl, and aralkyl, or together with Y forms a cyclic group including aryl, cyclic alkyl and heterocyclic alkyl;  
 X 3  is selected from the group consisting of -alkyl(hydroxy)-, -alkyl-, -alkynyl-, -aryl-, -carbonylalkyl-, -1,1-dihaloalkyl-, -alkoxyalkyl-, -alkyloxy-, -alkylthioalkyl-, -alkylthio-, -alkylaminocarbonyl-, -alkylcarbonylamino-, -alicyclic-, -aralkyl-, -alkylaryl-, -alkoxycarbonyl-, -carbonyloxyalkyl-, -alkoxycarbonylamino-, and -alkylaminocarbonylamino-, all optionally substituted; with the proviso that X 3  is not substituted with —COOR 2 , —SO 3 H, or —PO 3 R 2   2 ;  
 Y 3  is selected from the group consisting of —H, alkyl, alkenyl, alkynyl, aryl, alicyclic, aralkyl, aryloxyalkyl, alkoxyalkyl, —C(O)R 3 , —S(O) 2 R 3 , —C(O)—R 11 , —CONHR 3 , —NR 2   2 , and —OR 3 , all except H are optionally substituted;  
 each R 4  is independently selected from the group consisting of —H, and alkyl, or together R 4  and R 4  form a cyclic alkyl group;  
 R 5  is selected from the group consisting of lower alkyl, lower aryl, lower aralkyl, and lower alicyclic;  
 R 7  is independently selected from the group consisting of —H, lower alkyl, lower alicyclic, lower aralkyl, lower aryl, and —C(O)R 10 ;  
 R 8  is independently selected from the group consisting of —H, lower alkyl, lower aralkyl, lower aryl, lower alicyclic, —C(O)R 10 , or together they form a bidentate alkyl;  
 R 10  is selected from the group consisting of —H, lower alkyl, —NH 2 , lower aryl, and lower perhaloalkyl;  
 R 11  is selected from the group consisting of alkyl, aryl, —NR 2   2  and —OR 2 ; and  
 pharmaceutically acceptable prodrugs and salts thereof.  
 
     
     
         117 . The method of  claim 116  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         118 . The method of  claim 116  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         119 . The method of  claim 116  wherein said insulin sensitizer is a RXR ligand.  
     
     
         120 . The method of  claim 103  wherein M is R 5 —X— wherein R 5  is selected from the group consisting of:  
       
         
           
           
               
               
           
         
       
       wherein: 
 each G is independently selected from the group consisting of C, N, O, S, and Se, and wherein only one G may be O, S, or Se, and at most one G is N;  
 each G′ is independently selected from the group consisting of C and N and wherein no more than two G′ groups are N;  
 A is selected from the group consisting of —H, —NR 4   2 , —CONR 4   2 , —CO 2 R 3 , halo, —S(O)R 3 , —SO 2 R 3 , alkyl, alkenyl, alkynyl, perhaloalkyl, haloalkyl, aryl, —CH 2 OH; —CH 2 NR 4   2 , —CH 2 CN, —CN, —C(S)NH 2 , —OR 3 , —SR 3 , —N 3 , —NHC(S)NR 4   2 , —NHAc, and null;  
 each B and D are independently selected from the group consisting of —H, alkyl, alkenyl, alkynyl, aryl, alicyclic, aralkyl, alkoxyalkyl, —C(O)R 11 , —C(O)SR 3 , —SO 2 R 11 , —S(O)R 3 , —CN, —NR 9   2 , —OR 3 , —SR 3 , perhaloalkyl, halo, —NO 2 , and null, all except —H, —CN, perhaloalkyl, —NO 2 , and halo are optionally substituted;  
 E is selected from the group consisting of —H, alkyl, alkenyl, alkynyl, aryl, alicyclic, alkoxyalkyl, —C(O)OR 3 , —CONR 4   2 , —CN, —NR 9   2 , —NO 2 , —OR 3 , —SR 3 , perhaloalkyl, halo, and null, all except —H, —CN, perhaloalkyl, and halo are optionally substituted;  
 J is selected from the group consisting of —H and null;  
 X is an optionally substituted linking group that links R 5  to the phosphorus atom via 2-4 atoms, including 0-1 heteroatoms selected from N, O, and S, except that if X is urea or carbamate there is 2 heteroatoms, measured by the shortest path between R 5  and the phosphorus atom, and wherein the atom attached to the phosphorus is a carbon atom, and wherein X is selected from the group consisting of -alkyl(hydroxy)-, -alkynyl-, -heteroaryl-, -carbonylalkyl-, -1,1-dihaloalkyl-, -alkoxyalkyl-, -alkyloxy-, -alkylthioalkyl-, -alkylthio-, -alkylaminocarbonyl-, -alkylcarbonylamino-, -alkoxycarbonyl-, -carbonyloxyalkyl-, -alkoxycarbonylamino-, and -alkylaminocarbonylamino-, all optionally substituted; with the proviso that X is not substituted with —COOR 2 , —SO 3 H, or —PO 3 R 2   2 ;  
 R 2  is selected from the group consisting of R 3  and —H;  
 R 3  is selected from the group consisting of alkyl, aryl, alicyclic, and aralkyl;  
 each R 4  is independently selected from the group consisting of —H, and alkyl, or together R 4  and R 4  form a cyclic alkyl group;  
 each R 9  is independently selected from the group consisting of —H, alkyl, aralkyl, and alicyclic, or together R 9  and R 9  form a cyclic alkyl group;  
 R 11  is selected from the group consisting of alkyl, aryl, —NR 2   2 , and —OR 2 ;  
 and with the proviso that:  
 1) when G′ is N, then the respective A, B, D, or E is null;  
 2) at least one of A and B, or A, B, D, and E is not selected from the group consisting of —H or null;  
 3) when R 5  is a six-membered ring, then X is not any 2 atom linker, an optionally substituted -alkyloxy-, or an optionally substituted -alkylthio-;  
 4) when G is N, then the respective A or B is not halogen or a group directly bonded to G via a heteroatom;  
 5) when X is not a -heteroaryl- group, then R 5  is not substituted with two or more aryl groups;  
 and pharmaceutically acceptable prodrugs and salts thereof.  
 
     
     
         121 . The method of  claim 120  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         122 . The method of  claim 120  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         123 . The method of  claim 120  wherein said insulin sensitizer is a RXR ligand.  
     
     
         124 . The method of  claim 95  wherein said combination is administered orally.  
     
     
         125 . The method of  claim 98  wherein said combination is administered separately during the day.  
     
     
         126 . The method of  claim 98  wherein said combination is administered simultaneously during the day.  
     
     
         127 . A method of treating a mammal having a disease characterized by insulin resistance and/or hyperglycemia comprising the administration to said mammal an effective amount of an insulin sensitizer agent and an FBPase inhibiting amount of an FBPase inhibitor.  
     
     
         128 . The method of  claim 95  wherein said disease is characterized by insulin resistance.  
     
     
         129 . The method of  claim 95  wherein said disease is characterized by hyperglycemia.  
     
     
         130 . The method of  claim 95  wherein said disease is obesity.  
     
     
         131 . The method of  claim 95  wherein said disease is hypertension.  
     
     
         132 . The method of  claim 95  wherein said disease is polycystic ovarian syndrome.  
     
     
         133 . The pharmaceutical composition of  claim 9  wherein M is  
       
         
           
           
               
               
           
         
       
       wherein: 
 G″ is selected from the group consisting of —O— and —S—;  
 A 2 , L 2 , E 2 , and J 2  are selected from the group consisting of —NR 4   2 , —NO 2 , —H, —OR 2 , —SR 2 ; —C(O)NR 4   2 , halo, —COR 11 , —SO 2 R 3 , guanidinyl, amidinyl, aryl, aralkyl, alkyoxyalkyl, —SCN, —NHSO 2 R 9 , —CN, —S(O)R 3 , perhaloacyl, perhaloalkyl, perhaloalkoxy, C1-C5 alkyl, C2-C5 alkenyl, C2-C5 alkynyl, and lower alicyclic, or together L 2  and E 2  or E 2  and J 2  form an annulated cyclic group;  
 X 2  is selected from the group consisting of —CR 2   2 —, —CF 2 —, —OCR 2   2 —, —SCR 2   2 —, —O—C(O)—, —S—C(O)—, —O—C(S)—, and —NR 19 CR 2   2 —, and wherein in the atom attached to the phosphorus is a carbon atom; with the proviso that X 2  is not substituted with —COOR 2 , —SO 3 H, or —PO 3 R 2   2 ;  
 R 2  is selected from the group consisting of R 3  and —H;  
 R 3  is selected from the group consisting of alkyl, aryl, alicyclic, and aralkyl;  
 each R 4  is independently selected from the group consisting of —H, and alkyl, or together R 4  and R 4  form a cyclic alkyl group;  
 each R 9  is independently selected from the group consisting of —H, alkyl, aralkyl, and alicyclic, or together R 9  and R 9  form a cyclic alkyl group;  
 R 11  is selected from the group consisting of alkyl, aryl, —NR 2   2 , and —OR 2 ;  
 R 19  is selected from the group consisting of lower alkyl, —H, and —COR 2 ; and  
 pharmaceutically acceptable prodrugs and salts thereof.  
 
     
     
         134 . The compound of  claim 133  wherein G″ is —S—.  
     
     
         135 . The pharmaceutical composition of  claim 134  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         136 . The pharmaceutical composition of  claim 134  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         137 . The pharmaceutical composition of  claim 134  wherein said insulin sensitizer is a RXR ligand.  
     
     
         138 . The method of  claim 103  wherein M is:  
       
         
           
           
               
               
           
         
       
       wherein: 
 G″ is selected from the group consisting of —O— and —S—;  
 A 2 , L 2 , E 2 , and J 2  are selected from the group consisting of —NR 4   2 , —NO 2 , —H, —OR 2 , —SR 2 , —C(O)NR 4   2 , halo, —COR 11 , —SO 2 R 3 , guanidinyl, amidinyl, aryl, aralkyl, alkyoxyalkyl, —SCN, —NHSO 2 R 9 , —SO 2 NR 4   2 , —CN, —S(O)R 3 , perhaloacyl, perhaloalkyl, perhaloalkoxy, C1-C5 alkyl, C2-C5 alkenyl, C2-C5 alkynyl, and lower alicyclic, or together L 2  and E 2  or E 2  and J 2  form an annulated cyclic group;  
 X 2  is selected from the group consisting of —CR 2   2 —, —CF 2 —, —OCR 2   2 —, —SCR 2   2 —, —O—C(O)—, —S—C(O)—, —O—C(S)—, and —NR 19 CR 2   2 —, and wherein in the atom attached to the phosphorus is a carbon atom; with the proviso that X 2  is not substituted with —COOR 2 , —SO 3 H, or —PO 3 R 2   2 ;  
 R 2  is selected from the group consisting of R 3  and —H;  
 R 3  is selected from the group consisting of alkyl, aryl, alicyclic, and aralkyl;  
 each R 4  is independently selected from the group consisting of —H, and alkyl, or together R 4  and R 4  form a cyclic alkyl group;  
 each R 9  is independently selected from the group consisting of —H, alkyl, aralkyl, and alicyclic, or together R 9  and R 9  form a cyclic alkyl group;  
 R 11  is selected from the group consisting of alkyl, aryl, —NR 2   2 , and —OR 2 ;  
 R 19  is selected from the group consisting of lower alkyl, —H, and —COR 2 ; and pharmaceutically acceptable prodrugs and salts thereof.  
 
     
     
         139 . The method of  claim 138  wherein said insulin sensitizer is a thiazolidinedione.  
     
     
         140 . The method of  claim 138  wherein said insulin sensitizer is a PPARγ agonist.  
     
     
         141 . The method of  claim 138  wherein said insulin sensitizer is a RXR ligand.

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