What are sulfonylureas and what is their main adverse effect?

Sulfonylureas like glipizide, glyburide, and glimepiride lower blood glucose by stimulating pancreatic beta cells to secrete more insulin, regardless of blood glucose level. This insulin-independent stimulation makes hypoglycemia their most significant adverse effect, particularly in elderly patients, those with irregular eating patterns, and those with kidney impairment. Sulfonylureas also cause weight gain. They are inexpensive and effective, reducing hemoglobin A1C by 1 to 1.5 percent.