Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

Which agent is least likely to cause hypoglycemia in an active adult?

1. Glyburide

2. Sitagliptin

3. Repaglinide

4. Regular insulin

The correct answer is: Sitagliptin

Sitagliptin is least likely to cause hypoglycemia in an active adult because it works through a different mechanism compared to the other agents listed. Sitagliptin is a DPP-4 inhibitor that increases the levels of incretin hormones, which help to regulate glucose levels. It enhances insulin secretion in response to meals and decreases glucagon production, but it has a lower risk of causing hypoglycemia because it is glucose-dependent. This means that it primarily works to prevent excessive insulin secretion when blood glucose levels are normal or low. In contrast, agents like glyburide, repaglinide, and regular insulin can cause hypoglycemia, especially if the patient is active or does not consume an adequate amount of carbohydrates. Glyburide and repaglinide are insulin secretagogues that stimulate insulin release from the pancreas, which can lead to hypoglycemia if not matched with food intake or physical activity. Regular insulin, being a form of fast-acting insulin, can also lead to dangerously low blood sugar levels if not carefully monitored and dosed in relation to food consumption and activity levels. In summary, the distinct mechanism of action of sitagliptin, focusing on enhancing the body’s response to glucose rather than forcing