Hypoglycemia sulfonylureas causing

Renal/Hepatic function impairment Hepatic impairment may result in inadequate release of glucose in response to hypoglycemia. Renal impairment may cause decreased elimination of sulfonylureas leading to accumulation producing hypoglycemia. 

The most common adverse effect associated with sulfonylurea administration is hypoglycemia, which may be provoked by inadequate calorie intake (e.g., skipping a meal), or increased caloric needs (e.g., increased physical activity). Collectively, sulfonylureas also tend to cause weight gain, which is undesirable in individuals... 

D. One of the most important therapeutic objectives is to maintain normal glucose levels without producing frequent hypoglycemia. The main class of hypoglycemic drugs that have a propensity to cause hypoglycemia are the sulfonylureas, of which gly-buride is one. This is not a problem with the other choices. 

Biguanides cause hypoglycemia in 0.24 cases per 100 patient-years and it is more common when they are used in combination with a sulfonylurea (44). In 102 consecutive patients with drug-induced hospital-related hypoglycemic coma, 13 were taking metformin + glibenclamide and 3 were taking metformin + insulin (45). 

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