Type 2 diabetes - criteria for the selection of the antidiabetic drug

Deutsche medizinische Wochenschrift
Baptist Gallwitz

Abstract

Modern treatment of type 2 diabetes follows a patient-centered approach. Blood glucose targets depend on patients' individual situation e. g. age, disease duration and comorbidities. Today physicians can choose from several antidiabetics with different modes of action. Based on national guidelines on the step-wise treatment of type 2 diabetes these substances come into consideration after lifestyle intervention and initial pharmacotherapy with metformin proved to be insufficient. Results from clinical trials have in part shown significant differences between distinct drug classes regarding efficacy, risk of hypoglycemia and effect on body weight. Cardiovascular safety is another important aspect to consider. This balance between efficacy and safety is reflected more and more by analyzing a combined endpoint "reaching individual HbA1c-target without hypoglycemia and weight gain". A guideline- and evidence-based classification of present therapeutic options aims to support orientation in diabetes practice.

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