Whats the best dpp-4 inhibitor alternative to glimepiride?

Consult your plan. If you have normal renal function the preferred brand for your healthplan is the one to take - if you feel there is a need to change from a sulfonylurea to a dpp4i. Dpp4is have the same efficacy in lowering bs as glimeperide. Dpp4is have been implicated in increased pancreatitis and pancreatic and thyroid cancers. A better choice if you have good renal function is metformin.