Type 2 diabetes, alone or with metformin, a DPP-4 inhibitor or insulin, to bring blood sugar down when diet and exercise have not been sufficient.

Glimepiride closes a potassium channel on the insulin-producing beta cells of the pancreas. Closing it makes the cell fire and release the insulin it has stored, so more insulin reaches the blood after a meal and glucose moves into the tissues.

Low blood sugar, weight gain, nausea, stomach upset and dizziness. Occasional rash.

The main risk is hypoglycaemia, especially if a meal is missed, after alcohol, after unusual exercise, or in older people and those with kidney or liver disease. Learn the warning signs of a low sugar, shakiness, sweating, hunger and confusion, and always carry something sugary. Do not take it while fasting without discussing the dose first, including during Ramadan. It is a prescription medicine in Pakistan.