A study presented September 27, 2013 at the European Association for the Study of Diabetes in Barcelona announced that first line treatment with sulfonylureas (glipizide, glimiperide, etc.) can increase the risk of heart disease 2 fold when compared to metformin. It is interesting because these same concerns were brought up in the 1970s. What is recommended is continuing to use METFORMIN as a first line drug, but adding a “GLIPTIN” (Januvia, Onglyza or Tradjenta) to help control sugars.
This combination is great because it does not cause weight gain nor cause low sugar reactions.
So why do some patients use sulfonylureas? They are CHEAP generics and many insurance plans will not cover the newer GLIPTINS (which came on the market in 2006).