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Metformin is almost always the first medication that you primary physician will prescribe, along with dietary restrictions. There's a reason it's first on almost every single list of diabetes medications. The side-effects are super low and rare, and maximum dosage of it is rather high.

Three months later they check your A1C, and if you aren't responding to Metformin well enough then they'll slap on a second medication from one of the other categories. I think Sulfonylureas combine pretty well with it.

If you're still not responding well your primary will give up and send you to an endocrinologist, who should have enough knowledge of the alternatives to discuss which one is best for you. It's completely fair to say "I'd like to try XYZ because the side effect of <side effect> appeals to me".




Sulphonyl Ureas are known as secretagoges (They make the pancreas release more insulin) This has many metabolic drawbacks I won't go into.

They reason they are prescribed everytime for DM II by insurance plans is that they are the cheapest drug for diabetes in the world.

They are associated with either no improved mortality or worse mortality.

They naturally don't work in DM I




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