Clinical Approach to Medical Management of Type 2 Diabetes

Secretagogues:
Sulfonylureas and the Glinides
• Avoid using first generation SU agents and Glyburide
- higher risk of hypoglycemia, especially in elderly
(partially active metabolites)
• Glimepiride -significant biliary and fecal excretion of
the metabolites
• For patients with CKD or with unpredictable meal
schedule use meglitinides BID - TID with meals