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Sulfonylureas (SFUs)

Sulfonylureas (SFUs) are a type of medication that people with type 2 diabetes can use to lower blood sugar levels.

How do SFUs work?

Sulfonylureas work by stimulating the beta cells in the pancreas to release insulin. As a result, SFUs can cause hypoglycemia, since these drugs stimulate insulin release regardless of your blood glucose levels.

Who uses SFUs?

Sulfonylureas are used by people with type 2 diabetes to manage blood sugar levels, especially for people who need larger decreases in their blood sugar than what metformin can provide. However, SFUs can increase a person’s risk for hypoglycemia (low blood sugar) – especially for those also taking another diabetes medication or insulin. Discuss this risk with your healthcare team and whether you might benefit from another glucose-lowering medication, such as GLP-1 agonists or SGLT-2 inhibitors.

SFUs should not be used by people with type 1 diabetes or gestational diabetes due to the increased risk for severe hypoglycemia.

What are the benefits?

  • SFUs are cheaper than many other diabetes drugs and are available in generic brands.

  • SFUs are taken orally (as a pill), so they do not need to be injected.

  • SFUs have been used for a long time and are well-studied.

  • SFUs generally lead to a significant initial A1C reduction, although this effect usually decreases with time.

What are the drawbacks?

  • The use of SFUs can result in weight gain.

  • SFUs present a much higher risk of hypoglycemia compared to other type 2 diabetes drugs, such as GLP-1 and SGLT-2 inhibitors.

  • SFUs may overwork the pancreas by stimulating insulin release, therefore quickening the progression of type 2 diabetes.

Approved sulfonylurea drugs:

  • Glucotrol (Glipizide)

  • Diamicron (Gliclazide)

  • Glyburide (Glibenclamide)

  • Glimepiride

Last updated: June 28, 2021