Type 2 diabetes is a major risk factor for cardiovascular disease. At diagnosis more than 50% of patients already exhibit co-morbidities of the metabolic syndrome. Moreover, many individuals with pre-diabetes already show diabetes-related complications and cardiovascular disease. People with pre-diabetes represent a population already at high risk for cardiovascular and diabetes-related complications. Many of these people need a therapy with the focus on harmful effects of impaired glucose tolerance. Therefore prevention of diabetes, including drug treatment of people with abnormal glucose tolerance is of high medical and economic relevance. With a priority of lifestyle intervention drug treatment should be risk adjusted. Medical treatment should be considered for patients with diabetes-related complications, cardiovascular diseases and with co-morbidities of the metabolic syndrome.
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