• Sulfonylureas effectively reduce hemoglobin A1c by an expected 1.0%-2.0%. Maintaining glycemic control has been shown to lower morbidity secondary to microvascular complications including retinopathy, neuropathy, and nephropathy.• Glyburide is metabolized to active metabolites that may accumulate in patients with renal dysfunction and has been associated with a 2-fold incidence of hypoglycemia in elderly patients compared with glipizide.What is already known about this subject