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Sulfonylureas (SFUs)

How they work: Sulfonylureas continuously stimulate the release of insulin from the pancreas. However, there are significant risks of hypoglycemia and weight gain from taking sulfonylureas and there is concern that they may overwork the pancreas, thereby quickening the progression of type 2 diabetes.

Who Uses Them: Sulfonylureas are used by people with type 2 diabetes, especially those that need further glucose lowering beyond what metformin can provide.

Approved Drugs:

  • Glipizide

  • Gliclazide

  • Glibenclamide

  • Glimepiride

 

Pros

Cons

  • Cheap and generic

  • Well studied

  • Good initial A1c reduction, although the improvements usually decrease with time

  • Weight gain

  • Relatively high risk of hypoglycemia

  • Frequent dosing

  • Concern they overwork the pancreas and expedite the progression of type 2 diabetes