Abstract
Oral antidiabetic drugs are indicated in cases of newly diagnosed type 2 diabetes in which the therapy by influencing lifestyle, i.e.hypoenergetic diet and increase of physical activity failed. The other indication for oral antidiabetic therapy is failure of long term diet therapy in type 2 diabetes.
In persons with BMI higher than 25 is drug of first choise metformin. Metformin therapy increases sensitivity to insulin, due to combination of lower liver glucose output and increased peripheral uptake of glucose.
Metformin therapy is potentialy cardioprotective and metformin does not lead to the increase in body weight. The most serious side effect is lactic acidosis.
This is the reason, why metformin is contraindicated in liver, renal, cardiac or respiratory failure and in patients with history of higher alcohol intake. More often but less serious are cases of nausea, anorexy and diarrheoe after metformin.
Metformin is further contraindicated in pregnancy. When respecting all the restrictions and contraindications, metformine represents in many patients with type 2 diabetes an effective and affordable mean of treatment.