INS and diabetes mellitus: Use of sulfonylureas or thiazolidinediones in combination with insulin may cause more hypoglycemic episodes and greater weight gain.[11, 21] However, practice guidelines are unclear on whether these medications should be continued when initiating insulin.[7] Given how frequently these diabetes medications are prescribed, and how often they are continued through the insulin transition, it will be important for practice guidelines to provide more specific recommendations as to whether, and under which circumstances, they should be continued after insulin initiation.