Abstract
Type 1 diabetes is arelatively rare condition, today it has to be permanently treated with insulin. Its treatment is the responsibility of the diabetologist.
Type 2 diabetes is one of the most serious civilization diseases - it should be detected during preventive examinations. Every eort should be made to achieve normalization of glycemia as soon as possible.
While eective treatment of diabetes from its onset makes afavorable outcome after 20 years very likely, late initiation of therapy has little or no eect at all. As arule, treatment of patients with Type 2 diabetes is based on lifestyle measures and pharmacotherapy.
The antidiabetic agent of rst choice is metformin, followed by sulfonylureas. Of the alpha-glucosidase inhibitors, only acarbose is used in our country.
It is usually given in combination therapy and is the only oral antidiabetic that can be used in both types of diabetes. Among insulin sensitizers, pioglitazone has been shown to have benecial cardiovascular eect.
Recently gliptins have become aclass of oral antidiabetic agents commonly used worldwide; they are considered to be one of the most promising classes of oral antidiabetic agents that can be combined with many other antidiabetics including insulin. Injectable antidiabetics include incretin analogues signicantly reducing weight.
Arelatively new class of antidiabetic agents that increase renal glucose loss are glycosyls signicantly reducing weight and blood pressure. It is amost interesting class of drugs for their already conrmed and even anticipated cardiovascular eects.
Insulin and insulin analogues also play an important role in the treatment of diabetes. As new options in the treatment of diabetes continue to emerge, the algorithm of its treatment is constantly developing around the world - the Czech Diabetes Society, for example, stated in its guideline that the mechanisms of action of gliozins and their cardiovascular eects have move upward within the algorithm.
Bariatric surgery has been shown to reduce the risk of developing Type-2 diabetes by up to 40 times. From an economic point of view, the cost of surgery is oset by treatment-related savings within aperiod of two years; besides, bariatric surgery has asignicant impact on reducing mortality.