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Gliclazide is a sulfonylurea. It makes the pancreas release more insulin, regardless of what your blood glucose is doing at the time.
That last part is the key to understanding it. Metformin and the newer diabetes drugs work in glucose-dependent ways, so they rarely cause low blood sugar. Gliclazide pushes insulin out whether or not you have eaten — which is exactly why it can cause a hypo.
It is old, cheap, and genuinely effective at lowering blood glucose.
Newer agents — SGLT2 inhibitors and GLP-1 agonists — are now preferred where there is heart or kidney disease, because they protect those organs in ways sulfonylureas do not. Gliclazide remains a reasonable choice otherwise.
If you are unwell and not eating, gliclazide may need pausing. Take advice rather than guessing — both continuing it without food and stopping it during illness carry risks.
You must tell the DVLA if you take a sulfonylurea. You need to check your blood glucose before driving and every two hours on long journeys, and carry fast-acting carbohydrate in the car.
Hypoglycaemia — low blood sugar. Symptoms include sweating, trembling, hunger, palpitations, confusion, irritability and, if untreated, loss of consciousness.
Treat immediately with 15 to 20g of fast-acting carbohydrate — glucose tablets, a small glass of fruit juice, or full-sugar cola — then follow with a longer-acting carbohydrate such as a sandwich or biscuits.
A hypo caused by gliclazide can be prolonged and can recur hours later, because the drug is still working. Severe hypos need medical attention rather than just treatment at home.
Particular caution applies in older people, in anyone who lives alone, in those who skip meals, and in anyone whose job or driving makes a hypo especially dangerous.
Yes, to continue established treatment where control is stable and recent HbA1c and kidney function are available.
What we will always cover is hypoglycaemia — how to recognise it, how to treat it, what it means for driving, and what to do when you are unwell. That conversation matters more with gliclazide than with most diabetes medicines, and it is frequently skipped.
We do not manage newly diagnosed or poorly controlled diabetes remotely. That needs structured education, foot and eye screening, and a full annual review.
Gliclazide is one of the cheapest diabetes medicines available, which is a genuine advantage where cost matters.
Blood glucose test strips and a meter are part of the cost, and are needed with this medicine because of the hypo risk. Prescriptions for strips should accompany it.
Modified-release preparations cost slightly more and are taken once daily.
Do not stop it abruptly without advice — blood glucose will rise. Changes are made alongside HbA1c monitoring.
Type 2 diabetes remission through substantial weight loss is achievable and is the only route to coming off medication altogether. NHS low-calorie programmes have demonstrated this and are free in many areas.
Because it pushes the pancreas to release insulin whether or not you have eaten. Metformin works differently and does not force insulin out.
Yes. Sulfonylureas carry a hypo risk, so there are testing requirements before and during driving. Not declaring it can invalidate your insurance.
15 to 20g of fast-acting carbohydrate, then a longer-acting snack. Recheck after 15 minutes. Because gliclazide keeps working, hypos can return hours later — severe ones need medical attention.
In moderation and with food. Alcohol on an empty stomach markedly increases hypo risk and can delay recovery.
Usually a few kilograms. If weight is a concern, that is a genuine reason to discuss an alternative rather than accept it.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
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