Abstract: The object of the present invention is to provide a compound having a glucokinase-activating effect. A pharmaceutical composition comprising a compound represented by the general formula (I) or a pharmaceutically acceptable salt thereof as an active ingredient: wherein X means a nitrogen atom or CR6, wherein R6 means a hydrogen atom or a halogen atom; R1 means a hydrogen atom, a C1-C6 alkyl group, a C1-C6 alkoxy group or a C1-C6 alkylthio group; R2 means a hydrogen atom or a fluorine atom; R3 means a hydrogen atom or a C1-C6 alkyl group; and one of R4 and R5 means a hydrogen atom or a C1-C6 alkyl group, and the other means a C1-C6 alkylenecarboxylic acid, a C1-C6 alkylsulfonyl group, a C1-C6 alkylcarbonyl group, or CONH2.

Abstract: A spiro compound represented by the following formula (I) wherein R1 and R2 are the same or different and each is a hydrogen atom, a chlorine atom and the like, n is 1, 2 or 3, a bond containing a broken line is a single bond or a double bond, A is —X—(CH2)q—N(R3)(R4); a group represented by the following formula (a) and the like, wherein X is an oxygen atom or a sulfur atom, q is 2 or 3, R3 and R4 are the same or different and each is a C1-6 alkyl group and the like, or R3 and R4 optionally form, together with the adjacent nitrogen atom, a piperidine ring and the like optionally substituted by one or two C1-6 alkyl and the like, R5 is a C1-6 alkyl group and the like, R6 is a hydrogen atom and the like, and r and t are each independently one or two, or a pharmaceutically acceptable acid addition salt thereof.