[en] Blood Glucose/metabolism ; Cardiovascular Diseases/etiology/prevention & control ; Diabetes Mellitus, Type 2/drug therapy ; Drug Therapy, Combination ; Humans ; Hypoglycemic Agents/therapeutic use ; Metformin/therapeutic use ; Risk Factors ; Thiazolidinediones/therapeutic use
[en] Type 2 diabetes is a complex disease combining several disturbances in various organs, especially a defect of insulin secretion by the pancreas, an increased production of glucose by the liver and a reduced insulin-mediated glucose uptake by the skeletal muscle. Each of these abnormalities can be, at least partially, reversed by a specific pharmacological approach, an agent promoting insulin secretion (sulphonylurea, glinide), metformin and a thiazolidinedione (glitazone), respectively. A triple oral therapy with "sulphonylurea (glinide)--metformin--glitazone", targeting simultaneously the three main metabolic abnormalities of type 2 diabetes, deserves special attention. Promising results have been observed in recent clinical trials as far as blood glucose control and some other cardiovascular risk factors are concerned. The precise place of such oral triple therapy remains to be specified, at a late stage to delay the shift to insulin or earlier in the natural history of the disease, to avoid the decline of the number and/or function of beta cells and the resulting metabolic deterioration.