Insulin secretagogues side effects

If metformin alone does not control the HbAlc, then metformin and a sulfonylurea should be given. A thiazolidinedione can be substituted for either agent if unacceptable side effects occur, such as nausea or hypoglycaemia. A rapid-acting insulin secretagogue may be added for people with erratic lifestyles, as it can be given once daily. 

The main and most frequent side effect during therapy with insulin secretagogues is hypoglycaemia. Given the large number of patients treated with SUs, hypoglycaemia remains a major clinical concern even if the incidence is relatively low... 

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