[Therapy of type 2 diabetes. Critical evaluation of oral antidiabetic drugs].

Changes in lifestyle and eating habits always form the initial phase of treatment of type 2 diabetes. Sooner or later, type 2 diabetes is associated with a lack of insulin that makes treatment with insulin necessary. Today, however, modern oral antidiabetics make it possible to exert a selective positive influence on both insulin resistance and disturbed insulin secretion. Three main groups of substances are available. Among the stimulators of insulin secretion are the sulfonylureas (e.g. glibenclamide, glibonuride, glisoxepid, glimepiride), and the so-called prandial glucose regulators, such as repaglinide, which differ from the sulfonylureas both chemically and in their pharmacodynamic properties. The group of insulin sensitizers includes the biguanide, metformin and the thiazolidinediones or glitazones (rosiglitazone, pioglitazone). The third group are the alpha-glucosidase inhibitors, e.g. acarbose. In principle, these oral antidiabetics can be combined with one another.