Generally speaking, there is no such thing as “the drug with the least side effects”. Almost all hypoglycemic drugs have their own side effects, so please choose the hypoglycemic drug according to your specific situation and under the guidance of your doctor. The main types of hypoglycemic drugs are biguanides, thiazolidinediones, insulinotropic agents, alpha-glucosidase inhibitors, etc. Different hypoglycemic drugs have different side effects. Different hypoglycemic agents have different side effects. Biguanides, mainly metformin, have side effects such as gastrointestinal reactions like abdominal pain and bloating, skin allergies, lactic acidosis, and vitamin B12 deficiency. Alpha-glucosidase inhibitors are mainly acarbose, with common side effects of gastrointestinal reactions such as abdominal distension and increased flatulence. Sulfonylureas, such as glipizide, among the insulinotropic secretagogues, have side effects such as hypoglycemia, weight gain, skin irritation, and gastrointestinal symptoms such as abdominal distension and loss of appetite. The glargine class includes Repaglinide, etc., with side effects such as hypoglycemia and weight gain. Therefore, almost all hypoglycemic drugs have their own side effects. Patients who need to use hypoglycemic drugs for treatment should be treated with medication under the guidance of a doctor.