Research
Hormonal
Sulfonylureas have fewer cardiovascular side effects and similar mortality to metformin, with clinically irrelevant weight gain and rare hypoglycemia.
Sulfonylureas are often viewed negatively, but they may have fewer heart-related side effects than metformin and do not significantly impact mortality. Weight gain is minimal, and low blood sugar is rare. They remain a safe and effective option for many patients.
GoodSupportsMEDIUM confidence
In a recent Cochrane meta-analysis, second generation sulfonylureas had fewer cardiovascular side effects than metformin; mortality was the same. Weight gain as a side effect of these drugs is clinically not relevant: 1.3 kg in 2 years... and 1.7 kg in 10 years... Hypoglycemia caused by sulfonylureas is rare: about 0.5/patient/year
Why this rating
Based on a Cochrane meta-analysis and retrospective data.
Source
Limited Prospects of Success
Frank Meyer · Deutsches Ärzteblatt international · 2014
DOI 10.3238/arztebl.2014.0432c
narrative_review
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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