Which medication class is most likely to cause hypoglycemia as a side effect?

Sulfonylureas are the medication class most likely to cause hypoglycemia as a side effect. This occurs because sulfonylureas stimulate the pancreas to release more insulin, thereby lowering blood glucose levels. While increased insulin secretion can be beneficial for lowering high blood sugar, it can also lead to excessive insulin in the bloodstream, particularly if meals are skipped or if there is an unexpected change in physical activity.

In contrast, the other classes of medications listed do not have the same propensity to cause hypoglycemia. Biguanides, such as metformin, primarily work by decreasing glucose production in the liver and enhancing insulin sensitivity without increasing insulin secretion. Thiazolidinediones also improve insulin sensitivity but do not directly stimulate insulin release from the pancreas. Incretin mimetics primarily work by enhancing the secretion of insulin in response to meals but generally do so in a glucose-dependent manner, meaning they are less likely to cause hypoglycemia when not accompanied by food intake.

Understanding how each class functions is crucial for managing diabetes effectively and recognizing potential side effects, such as hypoglycemia, particularly with sulfonylureas.