[Therapy decision based on the glucose triad. Drug treatment of type 2 diabetes]

Abstract

For the treatment of type 2 diabetes we now have available a wide spectrum of oral antidiabetic agents and insulins that make it possible to offer the patient an individualized, pathophysiologically oriented therapy. Such treatment should be oriented to the two basic defects--insulin resistance and impaired early secretion of insulin--which can be assessed on the basis of fasting and postprandial blood sugar. Since monotherapy rarely suffices to correct the complex dysregulation, when close-to normalization of the glucose triad fasting blood glucose, postprandial blood glucose and HbA1C fails, early application of complementary combinations offer advantages, with preference being given to metformin in the overweight patient. This also applies to the combination with insulin.