<unk> s – as opposed to metformin, the thiazolidinediones, pramlintide and other newer treatments – may induce hypoglycemia as a result of excesses in insulin production and release. Hypoglycemia appears to happen more often with<unk> s than compared to other treatments.This typically occurs if the dose is too high, and the patient is fasting. Some people attempt to change eating habits to prevent this, however it can be counter productive. Like insulin,<unk> s can induce weight gain, mainly as a result of their effect to increase insulin levels and thus utilization of glucose and other metabolic fuels. Other side-effects are: gastrointestinal upset, headache and hypersensitivity reactions. The safety of<unk>  therapy in pregnancy is unestablished. Prolonged hypoglycemia (4 to 10 days) has been reported in children borne to mothers taking<unk> s at the time of delivery. Impairment of liver or kidney function increase the risk of hypoglycemia, and are contraindications. Since other antidiabetic drugs cannot be used either under these circumstances, insulin therapy is typically recommended during pregnancy and in liver and kidney failure, although some of the newer agents offer potentially better options. A 2011 Cochrane review found evidence that treatment of LADA using<unk> s lead to earlier insulin dependence in approximately 30% of cases. A more recent 2014 Cochrane review found tentative evidence that people treated with<unk> s have fewer non-fatal cardiovascular events than those treated with metformin (RR 0.7) but a higher risk of severe hypoglycemia (RR 5.6). There was not enough data available to determine the risk of mortality or of cardiovascular mortality. An earlier review by the same group found a statistically significant increase in the risk of cardiovascular death for first generation<unk> s relative to placebo (RR 2.6) but there was not enough data to determine the relative risk of first generation<unk> s relative to insulin (RR 1.4). Likewise it was not possible to determine the relative mortality risk of second generation<unk> s relative to metformin (RR 1.0), insulin (RR 1.0), or placebo. The FDA requires<unk> s to carry a label warning regarding increased risk of cardiovascular death. Second-generation<unk> s have increased potency by weight, compared to first-generation<unk> s. Similarly, ACCORD (Action to Control Cardiovascular Risk in Diabetes) and the VADT (Veterans Affairs Diabetes Trial) studies showed no reduction in heart attack or death in patients assigned to tight glucose control with various drugs.
Sulfonylurea
Aminosalicylate
Omega-3 carboxylic acids
Anthopleurin
Niclosamide
Allopurinol
Bisphosphonate
Retinoid