[New trends in therapy of diabetes. More freedom, fewer risks, comfortable insulin administration]

The incidence of diabetes mellitus is increasing worldwide. Strict metabolic control can prevent late sequelae of this disease. For this purpose, not only more potent drugs with fewer side effects are needed, but also user-friendly techniques and devices for self-monitoring of blood glucose and the less painful application of insulin (jet application, inhalable insulin). More user-friendly insulins are the rapid- and short-acting human insulin analogues, which do away with the bothersome injection/meal interval, and improve the postprandial glycemic response. New long-acting insulins reduce the frequency of injections and the occurrence of nocturnal hypoglycemia. Type 2 diabetics will presumable benefit from the use of the rapid, short-acting glinides, for example, by enabling a greater measure of eating freedom during the course of the day. The thiazolidinediones, a group of agents that enhance the effects of insulin in target tissue, reduce insulin resistance and improve insulin sensitivity.