Discontinuing other antidiabetic agents when starting insulin in type 2 diabetes

Should other antidiabetic agents be discontinued when starting insulin therapy in a patient with type 2 diabetes?

René Rodríguez-Gutiérrez, MD: Yes, particularly secretagogues, so sulfonylureas and gliptins. It is not a very good idea to keep them because they increase the risk of hypoglycemia.

However, I have to say that there are some randomized controlled trials that keep low-dose sulfonylureas with low-dose insulin. But in general, in practice I think it is just a good idea to go off medications that can increase the risk of hypoglycemia, and maybe keep the others that do not increase this risk.