With a plethora of new drugs for diabetes, and distinct differences in their mechanisms of action and non-glycaemic effects, the selection of a second-line medication to add to metformin is now a complex decision. Guidelines^1,2 offer some suggestions for individualisation of treatment, based on efficacy, side-effects, and cost. But the appropriate choice might be challenging for clinicians, patients, and payers, and older (and cheaper) drugs such as sulfonylureas and thiazolidinediones remain in use despite concerns about side-effects.

中文翻译：

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吡格列酮与磺脲类药物：旧糖尿病药物的心血管结局

由于有大量的糖尿病新药，并且它们的作用机制和非血糖效应存在明显差异，选择二线药物添加到二甲双胍现在是一个复杂的决定。指南^1,2根据疗效、副作用和成本为个体化治疗提供了一些建议。但对于临床医生、患者和付款人来说，适当的选择可能具有挑战性，并且尽管担心副作用，但磺脲类药物和噻唑烷二酮类等较老（且更便宜）的药物仍在使用。