Sulfonylureas are commonly prescribed oral anti-hyperglycaemic agents for the management of diabetes.

According to the International Diabetes Federation (IDF) guidelines:

• Sulfonylureas (except Glibenclamide/Glyburide) are recommended for patients who are not tolerant to Metformin.
• Sulfonylureas (except Glibenclamide/Glyburide), Sodium–glucose co-transporter-2 inhibitors (SGLT2is), or Dipeptidyl peptidase 4 (DPP-4) inhibitors can be prescribed in combination with Metformin.
• It is advised to educate patients regarding the prevention, recognition, and management of hypoglycaemia while initiating sulfonylureas.

As per the recommendations of the World Health Organisation (WHO):

• When Metformin monotherapy fails to attain glycaemic control, or for patients with Metformin intolerance, sulfonylureas are recommended.
• The usage of modern sulfonylureas, such as Gliclazide, is advised to ensure better safety.

According to the European Association for the Study of Diabetes (EASD) recommendations:

• Compared to lifestyle interventions alone, the addition of sulfonylureas effectively mitigates the cardiovascular risk. Therefore, it is recommended in patients with type 2 diabetes mellitus (T2DM).
• Relatively lesser adverse events, such as hypoglycaemia and cardiovascular toxicity, are associated with the use of newer sulfonylureas, such as Glimepiride.