[New differential therapy of type 2 diabetes]

A variety of different drugs with distinct approaches are available for the treatment of type 2 diabetes. Different treatment options, as well as new developments, are needed, since an acceptable quality of glucose control often requires drug combinations. Furthermore, type 2 diabetes is known as a heterogeneous disease that is characterized by different phases and individual characteristics, such as risk profiles and contraindications. In particular the impact of antihyperglycemic therapies on cardiovascular risk, body weight and the risk for hypoglycemia is important, but also the consideration of other co-morbidities, occupational and social aspects plays a role. So far, each therapeutic step is based on lifestyle-interventions and, if possible, metformin. Dipeptidylpeptidase 4 (DPP 4) inhibitors und glucagon-like peptid 1 (GLP 1) mimetics represent a new important tool in the differential therapy of type 2 diabetes. The advantage of incretin-based concepts is an improvement of glucose quality without induction of hypoglycemia and additional weight gain. It is, however, still not known, whether these advantages will still be seen in end point studies, e. g. concerning the cardiovascular risk.