[Optimized diabetes therapy in type 2 diabetics].
BACKGROUND
With the prevalence of type 2 diabetes mellitus having increased to approximately 8% during recent years and a further rise likely, type 2 diabetes will develop into a major health care problem in Europe. There are roughly 8 million diabetics in Germany, with another 4 million estimated unknown case.


METHODS
Diabetes is an accepted risk factor in the development of micro- and macrovascular complications. These complications generate enormous costs in our health care system. The optimal treatment of diabetic complications will minimize the cost to the health care system in the long run. Therefore, it is necessary to relay current therapeutic guidelines to medical personnel on a widespread basis.


OBJECTIVE
This publication summarizes current therapeutic options in glycemic control of type 2 diabetics which correspond to 95% of all diabetics. Recently, a national guideline has been developed by the "Arzneimittelkommission der deutschen Arzteschaft", the "Deutsche Diabetes- Gesellschaft", the "Fachkommission Diabetes Sachsen", the "Deutsche Gesellschaft für Innere Medizin e. V.", and the "Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften". In this guideline, treatment recommendations are made according to the criteria of evidence-based medicine. It is the basis of this review. In addition, the significance of the modern option of functional insulin therapy (FIT) in the treatment of type 2 diabetes will be explained. In closing, innovative alternatives of applying insulin will be discussed. Unquestionably, all other risk factors such as hypertension and/or hyperlipidemia also have to be treated optimally. These risk factors will not be discussed in this publication.
Clemens
Andreas
A
Medizinische Klinik C, Stoffwechselzentrum des Klinikums der Stadt Ludwigshafen, Ludwigshafen. a_clemens@gmx.de
Riemann
Jürgen F
JF
Siegel
Erhard G
EG
D000293:Adolescent; D000328:Adult; D001549:Benzamides / Q000008:administration & dosage / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002648:Child; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D003927:Diet, Diabetic; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D008297:Male; D008687:Metformin / Q000008:administration & dosage / Q000627:therapeutic use; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012138:Respiratory Therapy; D012307:Risk Factors; D013453:Sulfonylurea Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors; D015431:Weight Loss
D001549:Benzamides; D001786:Blood Glucose; D008078:Cholesterol, LDL; D007004:Hypoglycemic Agents; D007328:Insulin; D013453:Sulfonylurea Compounds; C030516:meglitinide; D008687:Metformin