Which oral medication combined with sulfonylureas increases hypoglycemia risk?

The combination of sulfonylureas with incretin mimetics (GLP-1s) can increase the risk of hypoglycemia. Sulfonylureas work by stimulating insulin secretion from the pancreas, thus lowering blood glucose levels. Incretin mimetics, on the other hand, enhance insulin secretion in response to meals and also inhibit glucagon release, leading to lower blood glucose levels as well.

When these two classes of medications are used together, the synergistic effect can lead to a more pronounced reduction in blood glucose levels. This raises the potential for hypoglycemia, especially if meals are missed, or if the dosing of either medication is not properly managed. It's important for clinicians to monitor patients closely when these medications are combined to prevent such adverse effects.

In contrast, the other medication classes listed, such as metformin, alpha-glucosidase inhibitors, and thiazolidinediones, do not typically result in increased insulin secretion and, therefore, pose a lower risk of causing hypoglycemia when used alongside sulfonylureas. Each of these agents works through different mechanisms and offers a complementary approach to managing blood glucose without significantly increasing the risk of low blood sugar levels.