[Oral antidiabetic drugs in 2003]

Treatment of patients with type 2 diabetes includes in the first place diet, weight reduction, exercise, and the control of cardiovascular risk factors. Because the compliance with these interventions is not sustained, drug therapy is required for most patients. There are five therapeutic options in type 2 diabetes: increase insulin release with sulfonylureas or glinides; increase insulin action with biguanides or glitazones; modify intestinal absorption of carbohydrate with a glucosidase inhibitor or absorption of fat with a lipase inhibitor; associate these drugs or use new therapeutic agents; administer exogenous insulin. Many patients with type 2 diabetes will overtime need combination of different drugs and insulin, but the best strategy is not known and more trials are needed to give better evidence for the therapeutic choices.