Columbia Technology Ventures

Diabetes management through oral anti-inflammatories

Lead Inventor: Steven P. Engebretson, D.M.D., M.S.

Type 2 diabetes management with oral anti-inflammatories:
Despite many advances in treatment, Type 2 diabetes is one of the largest health problems worldwide. Approximately 24 million Americans are afflicted, costing an estimated $116 billion in direct medical costs and nearly $60 billion in disability, lost productivity, and premature mortality. Effective diabetes management is complex, expensive, and demands a high level of commitment from the patient. Clearly, there is a great need for improved treatment strategies, particularly those that are cost-efficient and minimally intrusive to the patient.

Oral anti-inflammatories controls glucose in diabetic patients:
Elevated levels of pro-inflammatory cytokines, such as tumor necrosis factor (TNF), are associated with worsened glycemic control in diabetic patients. In particular, TNF reduces function of the insulin receptor. Research by the inventor and others has shown that chronic periodontitis is a significant contributor to systemic TNF levels. In turn, hyperglycemia was found to stimulate local interleukin-1b (IL-1) levels, which contributes to systemic TNF levels, creating a vicious cycle of inflammation and impaired glucose control. This invention describes a means for interrupting this process, through the use of an anti-inflammatory Ketorolac oral rinse. Efficacy of treatment can be easily assessed by assaying IL-1 levels in the gingival crevicular fluid, as well as standard blood sugar monitoring via hemoglobin A1c. This treatment strategy offers a novel, inexpensive, and easy-to-use means for improving glucose control in diabetic patients.

Applications:
• Reduction of circulating TNF in Type 2 diabetes, leading to improved insulin sensitivity and glucose control
• Potentially useful in other conditions in which systemic pro-inflammatory cytokines are involved (e.g., cardiovascular disease)

Advantages:
• A completely novel approach to diabetes management that would be additive (rather than competitive) with existing treatments
• Simultaneous treatment of both diabetes and frequently co-morbid periodontal disease
• Daily oral rinse is simple and non-invasive, and therefore likely to lead to improved patient compliance relative to existing treatments
• Ketorolac is currently FDA-approved for systemic and opthalmic use, streamlining path to market
• Ketorolac could be developed and marketed in parallel with an oral IL-1 assay for diagnosis, patient selection, and/or treatment monitoring


Patent Status: Patent Pending (US20050152850A1) ~ see links below.

Licensing Status: Available for Licensing and Sponsored Research Support

Publications: Engebretson S, Chertog R, Nichols A, Hey-Hadavi J, Celenti R, Grbic J. (2007) Journal of Clinical Periodontology. 34(1):18-24. Plasma levels of tumour necrosis factor-alpha in patients with chronic periodontitis and type 2 diabetes.