Abstract
The new EASD and ADA 2015 algorithm continues to significantly utilise drugs directly increasing the patient's sensitivity to insulin - metformin and pioglitazone. Metformin is currently considered to be the only available drug for patients with prediabetes and it is the first choice treatment in patients with type 2 diabetes.
Pioglitazone can be administered in the second step of the treatment and it can be used in step 3 as well. Insulin sensitisers are thus a significant part of diabetes therapy.
Apart from an important antidiabetic effect, other effects of metformin are significant as well, for example lower occurrence of tumours. Pioglitazone has other effects as well, for example it affects insulin secretion.
Some new antidiabetics (gliptins and gliflozins) indirectly increase insulin sensitivity. Because diabetics live with a permanently increased cardiovascular risk, positive cardiovascular effects of metformin and pioglitazone are worth stressing.