Overview of current therapy in diabetes mellitus

Diabetes mellitus can be found world wide and is a disease effecting carbohydrate metabolism. An increase in the number of diabetic patients from 189 billion today to 324 billion worldwide in 2025 is predicted. More than ninety percent suffer from type 2 diabetes. Similar numbers are mentioned for the pre-diabetic stage of impaired glucose tolerance (IGT) and metabolic syndrome. It is an important task for the future to use adequate diagnosis-finding methods and therapies to discern and treat the disturbance of carbohydrate metabolism as early as possible and perhaps slow down further progress in the case of IGT or metabolic syndrome. This should minimize the risk of cardiovascular or organic damage. In contrast to the treatment of type 1 diabetes with intensive insulin regimens, therapy for type 2 diabetes has changed noticeably in the last years. All treatment forms have to account for the results of recent studies which show evidence that long- and short-dated elevation of blood glucose, mostly postprandial appearing peaks can lead to vascular damage with all consequences. The main goal should be to adapt treatment individually, estimating the stage of the disease, the risk of developing or progression of micro- or/and macrovascular complications, present risk factors, age and abilities. Non-pharmacologic and pharmacologic approaches are available.