[Controversial therapeutic strategies in the treatment of type 2 diabetes mellitus].
At the time of the diagnosis insulin resistance is present in the majority of type 2 diabetics. Only in those type 2 diabetics who are of normal weight at diagnosis must a disturbance of insulin secretion be assumed. These pathophysiological facts, discovered in recent years, mandate a differentiated treatment of type 2 diabetics. The primary aim must be the treatment of the insulin resistance. Insulinotropic drugs are indicated only during the further course of the disease. The use of glitazones makes possible a largely causal treatment of insulin resistance. Over the long term better glycemic control is achieved with glitazones rather than sulfonylureas. As a secondary effect, the insulin-producing beta cells are protected, and such cardiovascular risk factors as diabetic dyslipoproteinemia, hypertension or microalbuminuria are favorably influenced.
Schumm-Draeger
P M
PM
Klinikum München, GmbH, Krankenhaus Bogenhausen. SchummDrager@extern.lrz-muenchen.de
D002318:Cardiovascular Diseases / Q000517:prevention & control; D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D005500:Follow-Up Studies; D005907:Gliclazide / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007333:Insulin Resistance; D008687:Metformin / Q000008:administration & dosage / Q000627:therapeutic use; D000077205:Pioglitazone; D012307:Risk Factors; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors
D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D008687:Metformin; D005907:Gliclazide; D000077205:Pioglitazone