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Table of Contents
Effects on Type 2 Diabetes
Sulfonylureas vs. Metformin
Potential Side Effects
Drug Interactions
Frequently Asked Questions
This article discusses everything you need to know about how sulfonylureas work for type 2 diabetes and what to expect when taking the drug.
Courtney Hale / Getty Images
Effect of Sulfonylureas on Type 2 Diabetes
People with type 2 diabetes must manage theirblood sugar levelsbecause their bodies do not respond to insulin. As a result, sugar levels build up in the blood and cause health issues.
Can People With Type 1 Diabetes Take Sulfonylureas?In people withtype 1 diabetes, the body does not produce insulin. Because of that, sulfonylureas can only be used for those with type 2 diabetes.
Can People With Type 1 Diabetes Take Sulfonylureas?
In people withtype 1 diabetes, the body does not produce insulin. Because of that, sulfonylureas can only be used for those with type 2 diabetes.
Although both drugs treat type 2 diabetes, Metformin is often the first-choice therapy and is a better choice for people with health complications such as reduced kidney function.
In some cases, the two drugs will be taken in a combinational approach to help better control diabetes and blood sugar levels.
The safety level of both medications depends highly on a person’s health history, any complications or health issues they have outside of type 2 diabetes, and their healthcare provider’s recommendations. That said, some research has found that taking sulfonylureas can increase the risk of cardiovascular complications over metformin use.
How to ChooseYour healthcare provider will provide a medication recommendation based on their knowledge of your current state of health.
How to Choose
Your healthcare provider will provide a medication recommendation based on their knowledge of your current state of health.
Many different medications fall under the umbrella of sulfonylureas.
Hypoglycemia and SulfonylureasHypoglycemia occurs when blood sugar levels become dangerously low. In people taking sulfonylureas, too much insulin can build up in the body and cause low blood sugar levels. People can experience a fast heartbeat, nervousness or anxiety, irritability or confusion, and dizziness when this happens. In the most severe cases, coma, brain damage, and death can occur from hypoglycemia.
Hypoglycemia and Sulfonylureas
Hypoglycemia occurs when blood sugar levels become dangerously low. In people taking sulfonylureas, too much insulin can build up in the body and cause low blood sugar levels. People can experience a fast heartbeat, nervousness or anxiety, irritability or confusion, and dizziness when this happens. In the most severe cases, coma, brain damage, and death can occur from hypoglycemia.
Some medications should not be taken at the same time as sulfonylureas or hold a higher risk for adverse effects, such as:
Medications, Supplements, and SulfonylureasWhen you are about to begin taking sulfonylureas, be sure to tell your healthcare provider about all medications and supplements you take, whether they’re prescribed or over the counter (OTC). It’s vital to ensure that you do not experience adverse effects because of drug interactions.
Medications, Supplements, and Sulfonylureas
When you are about to begin taking sulfonylureas, be sure to tell your healthcare provider about all medications and supplements you take, whether they’re prescribed or over the counter (OTC). It’s vital to ensure that you do not experience adverse effects because of drug interactions.
Ask an Expert: What Are Barriers to Type 2 Diabetes Treatment?
Summary
All medications have side effects. Some are more severe than others and require monitoring. If you experience side effects, it’s essential to contact your healthcare provider. They can determine if the medication is still suitable for you based on your experience, how well your blood sugar is managed, and what other drugs or supplements you are taking.
A Word From Verywell
Type 2 diabetes isn’t always easy to cope with, but it can be managed effectively with medications such as sulfonylureas. They are generally considered safe, so if your healthcare recommends them, it’s probably for a good reason.
Frequently Asked QuestionsThe majority of sulfonylureas are considered safe when taken correctly. However, some come with side effects and an increased risk of harmful complications. According to research, the best sulfonylurea is glimepiride.Learn MoreList of Oral Diabetes MedicationsYour current state of health and health history will play a role in which medication is chosen for managing type 2 diabetes. When choosing between metformin and sulfonylureas, many factors are in play. Typically, metformin is the preferred choice for people who are more at risk for hypoglycemia or those with chronic kidney disease.Learn MoreMetformin Is Not Working: How to Tell and What to DoMany older adults may have to be wary of sulfonylureas for managing their type 2 diabetes. That is because the medication can increase the risk of hypoglycemia. Hypoglycemia can cause issues such as dizziness that may increase the risk of falls in older adults and the risk of harmful fractures.Learn MoreHypoglycemic Episode Symptoms, Complications, and More
The majority of sulfonylureas are considered safe when taken correctly. However, some come with side effects and an increased risk of harmful complications. According to research, the best sulfonylurea is glimepiride.Learn MoreList of Oral Diabetes Medications
The majority of sulfonylureas are considered safe when taken correctly. However, some come with side effects and an increased risk of harmful complications. According to research, the best sulfonylurea is glimepiride.
Learn MoreList of Oral Diabetes Medications
Your current state of health and health history will play a role in which medication is chosen for managing type 2 diabetes. When choosing between metformin and sulfonylureas, many factors are in play. Typically, metformin is the preferred choice for people who are more at risk for hypoglycemia or those with chronic kidney disease.Learn MoreMetformin Is Not Working: How to Tell and What to Do
Your current state of health and health history will play a role in which medication is chosen for managing type 2 diabetes. When choosing between metformin and sulfonylureas, many factors are in play. Typically, metformin is the preferred choice for people who are more at risk for hypoglycemia or those with chronic kidney disease.
Learn MoreMetformin Is Not Working: How to Tell and What to Do
Many older adults may have to be wary of sulfonylureas for managing their type 2 diabetes. That is because the medication can increase the risk of hypoglycemia. Hypoglycemia can cause issues such as dizziness that may increase the risk of falls in older adults and the risk of harmful fractures.Learn MoreHypoglycemic Episode Symptoms, Complications, and More
Many older adults may have to be wary of sulfonylureas for managing their type 2 diabetes. That is because the medication can increase the risk of hypoglycemia. Hypoglycemia can cause issues such as dizziness that may increase the risk of falls in older adults and the risk of harmful fractures.
Learn MoreHypoglycemic Episode Symptoms, Complications, and More
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sola D, Rossi L, Schianca GPC, Maffioli P, et al.Sulfonylureas and their use in clinical practice.Arch Med Sci.2015 Aug 12;11(4):840-8. doi:10.5114/aoms.2015.53304Medline Plus.Glyburide.Nasri H, Rafieian-Kopaei M.Metformin: current knowledge.J Res Med Sci.2014 Jul;19(7):658-64.Roumie CL, Chipman J, Min JY, Hackstadt AJ, Hung AM, Greevy RA Jr, Grijalva CG, Elasy T, Griffin MR.Association of treatment with metformin vs sulfonylurea with major adverse cardiovascular events among patients with diabetes and reduced kidney function.JAMA.2019 Sep 24;322(12):1167-1177. doi:10.1001/jama.2019.13206Madsen KS, Kähler P, Kähler LK, et al.Metformin and sulphonylurea (second‐ or third‐generation) combination therapy for adults with type 2 diabetes mellitus.Cochrane Database Syst Rev.2016 Sep 26;2016(9):CD012368. doi:10.1002/14651858.CD012368Douros A, Dell’Aniello S, Yu OHY, et al.Sulfonylureas as second-line drugs in type 2 diabetes and the risk of cardiovascular and hypoglycemic events: Population-based cohort.BMJ. 2018;362:k2693. doi:10.1136/bmjk2693.National Institute of Diabetes and Digestive and Kidney Diseases.Sulfonylureas, Second Generation. 2018.Nishihama K, Eguchi K, Maki K, et al.Sudden death associated with severe hypoglycemia in a diabetic patient during sensor-augmented pump therapy with the predictive low glucose management system.Am J Case Rep.2021 Jan 19;22:e928090. doi:10.12659/AJCR.928090Straight Healthcare.Sulfonylureas.Kalra S, Aamir AH, Raza A, et al.Place of sulfonylureas in the management of type 2 diabetes mellitus in South Asia: A consensus statement.Indian J Endocrinol Metab.2015 Sep-Oct;19(5):577-96. doi:10.4103/2230-8210.163171Lapane KL, Yang S, Brown MJ, et al.Sulfonylureas and risk of falls and fractures: A systematic review.Drugs Aging.2013 Jul;30(7):527-47. doi:10.1007/s40266-013-0081-0
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sola D, Rossi L, Schianca GPC, Maffioli P, et al.Sulfonylureas and their use in clinical practice.Arch Med Sci.2015 Aug 12;11(4):840-8. doi:10.5114/aoms.2015.53304Medline Plus.Glyburide.Nasri H, Rafieian-Kopaei M.Metformin: current knowledge.J Res Med Sci.2014 Jul;19(7):658-64.Roumie CL, Chipman J, Min JY, Hackstadt AJ, Hung AM, Greevy RA Jr, Grijalva CG, Elasy T, Griffin MR.Association of treatment with metformin vs sulfonylurea with major adverse cardiovascular events among patients with diabetes and reduced kidney function.JAMA.2019 Sep 24;322(12):1167-1177. doi:10.1001/jama.2019.13206Madsen KS, Kähler P, Kähler LK, et al.Metformin and sulphonylurea (second‐ or third‐generation) combination therapy for adults with type 2 diabetes mellitus.Cochrane Database Syst Rev.2016 Sep 26;2016(9):CD012368. doi:10.1002/14651858.CD012368Douros A, Dell’Aniello S, Yu OHY, et al.Sulfonylureas as second-line drugs in type 2 diabetes and the risk of cardiovascular and hypoglycemic events: Population-based cohort.BMJ. 2018;362:k2693. doi:10.1136/bmjk2693.National Institute of Diabetes and Digestive and Kidney Diseases.Sulfonylureas, Second Generation. 2018.Nishihama K, Eguchi K, Maki K, et al.Sudden death associated with severe hypoglycemia in a diabetic patient during sensor-augmented pump therapy with the predictive low glucose management system.Am J Case Rep.2021 Jan 19;22:e928090. doi:10.12659/AJCR.928090Straight Healthcare.Sulfonylureas.Kalra S, Aamir AH, Raza A, et al.Place of sulfonylureas in the management of type 2 diabetes mellitus in South Asia: A consensus statement.Indian J Endocrinol Metab.2015 Sep-Oct;19(5):577-96. doi:10.4103/2230-8210.163171Lapane KL, Yang S, Brown MJ, et al.Sulfonylureas and risk of falls and fractures: A systematic review.Drugs Aging.2013 Jul;30(7):527-47. doi:10.1007/s40266-013-0081-0
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sola D, Rossi L, Schianca GPC, Maffioli P, et al.Sulfonylureas and their use in clinical practice.Arch Med Sci.2015 Aug 12;11(4):840-8. doi:10.5114/aoms.2015.53304Medline Plus.Glyburide.Nasri H, Rafieian-Kopaei M.Metformin: current knowledge.J Res Med Sci.2014 Jul;19(7):658-64.Roumie CL, Chipman J, Min JY, Hackstadt AJ, Hung AM, Greevy RA Jr, Grijalva CG, Elasy T, Griffin MR.Association of treatment with metformin vs sulfonylurea with major adverse cardiovascular events among patients with diabetes and reduced kidney function.JAMA.2019 Sep 24;322(12):1167-1177. doi:10.1001/jama.2019.13206Madsen KS, Kähler P, Kähler LK, et al.Metformin and sulphonylurea (second‐ or third‐generation) combination therapy for adults with type 2 diabetes mellitus.Cochrane Database Syst Rev.2016 Sep 26;2016(9):CD012368. doi:10.1002/14651858.CD012368Douros A, Dell’Aniello S, Yu OHY, et al.Sulfonylureas as second-line drugs in type 2 diabetes and the risk of cardiovascular and hypoglycemic events: Population-based cohort.BMJ. 2018;362:k2693. doi:10.1136/bmjk2693.National Institute of Diabetes and Digestive and Kidney Diseases.Sulfonylureas, Second Generation. 2018.Nishihama K, Eguchi K, Maki K, et al.Sudden death associated with severe hypoglycemia in a diabetic patient during sensor-augmented pump therapy with the predictive low glucose management system.Am J Case Rep.2021 Jan 19;22:e928090. doi:10.12659/AJCR.928090Straight Healthcare.Sulfonylureas.Kalra S, Aamir AH, Raza A, et al.Place of sulfonylureas in the management of type 2 diabetes mellitus in South Asia: A consensus statement.Indian J Endocrinol Metab.2015 Sep-Oct;19(5):577-96. doi:10.4103/2230-8210.163171Lapane KL, Yang S, Brown MJ, et al.Sulfonylureas and risk of falls and fractures: A systematic review.Drugs Aging.2013 Jul;30(7):527-47. doi:10.1007/s40266-013-0081-0
Sola D, Rossi L, Schianca GPC, Maffioli P, et al.Sulfonylureas and their use in clinical practice.Arch Med Sci.2015 Aug 12;11(4):840-8. doi:10.5114/aoms.2015.53304
Medline Plus.Glyburide.
Nasri H, Rafieian-Kopaei M.Metformin: current knowledge.J Res Med Sci.2014 Jul;19(7):658-64.
Roumie CL, Chipman J, Min JY, Hackstadt AJ, Hung AM, Greevy RA Jr, Grijalva CG, Elasy T, Griffin MR.Association of treatment with metformin vs sulfonylurea with major adverse cardiovascular events among patients with diabetes and reduced kidney function.JAMA.2019 Sep 24;322(12):1167-1177. doi:10.1001/jama.2019.13206
Madsen KS, Kähler P, Kähler LK, et al.Metformin and sulphonylurea (second‐ or third‐generation) combination therapy for adults with type 2 diabetes mellitus.Cochrane Database Syst Rev.2016 Sep 26;2016(9):CD012368. doi:10.1002/14651858.CD012368
Douros A, Dell’Aniello S, Yu OHY, et al.Sulfonylureas as second-line drugs in type 2 diabetes and the risk of cardiovascular and hypoglycemic events: Population-based cohort.BMJ. 2018;362:k2693. doi:10.1136/bmjk2693.
National Institute of Diabetes and Digestive and Kidney Diseases.Sulfonylureas, Second Generation. 2018.
Nishihama K, Eguchi K, Maki K, et al.Sudden death associated with severe hypoglycemia in a diabetic patient during sensor-augmented pump therapy with the predictive low glucose management system.Am J Case Rep.2021 Jan 19;22:e928090. doi:10.12659/AJCR.928090
Straight Healthcare.Sulfonylureas.
Kalra S, Aamir AH, Raza A, et al.Place of sulfonylureas in the management of type 2 diabetes mellitus in South Asia: A consensus statement.Indian J Endocrinol Metab.2015 Sep-Oct;19(5):577-96. doi:10.4103/2230-8210.163171
Lapane KL, Yang S, Brown MJ, et al.Sulfonylureas and risk of falls and fractures: A systematic review.Drugs Aging.2013 Jul;30(7):527-47. doi:10.1007/s40266-013-0081-0
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