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Kidney or Liver Issues People with mild to moderate kidney or liver impairment can usually take semaglutide at standard doses

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1 Metformin Class Biguanide First-line drug for type 2 diabetes Mechanism of Action Decreases hepatic glucose production Increases insulin sensitivity Improves peripheral glucose uptake Does NOT cause insulin release Benefits First-line therapy No weight gain (may cause weight loss) Low risk of hypoglycemia Cardiovascular benefit Side Effects Nausea, diarrhea (common early) Vitamin B12 deficiency (long-term use) Rare: Lactic acidosis (especially in renal failure) Contraindications Severe kidney failure Severe liver disease Severe hypoxia/sepsis 2 Glimepiride Class Sulfonylurea Mechanism of Action Stimulates pancreatic -cells Increases insulin secretion Benefits Effective in lowering blood glucose Useful when metformin alone is insufficient Side Effects Hypoglycemia (important!) Weight gain Rare allergic reactions Caution Elderly patients Irregular meals (risk of hypoglycemia) Kidney impairment Metformin vs Glimepiride: Diabetes Medications Compared Metformin & Glimepiride Both are oral antidiabetic drugs used mainly in type 2 diabetes mellitus, but they work differently