Oral Antidiabetics

The prevalence of diabetes continues to increase worldwide. Traditionally, diabetes in its adult form has not been considered a serious life-threatening disease. This attitude needs to be changed because the complications asso­ ciated with the adult form of diabetes affect almost every organ system. The high morbidity and mortality of non-insulin-dependent diabetes mellitus (NIDDM) suggest that current treatment strategies are unsatisfactory. We therefore face an urgent need for new therapeutic approaches. When the first Handbook 0/ Oral Antidiabetics was edited by H. Maske in 1971, the risks and benefits associated with the use of oral antidiabetics were still under discussion. Nowadays, oral antidiabetics hold a strong posi­ tion in the long-term treatment of diabetes. Roughly 30% -50% of the patients with diabetes in Europe and the United States are treated with oral antidiabetics, chiefly sulfonylureas. While acknowledging the value of the ß­ cytotropic sulfonylureas, we also need to recognize important limitations of their use, e.g., in the treatment of obese diabetic patients.