Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

Which of the following is NOT a concern with the medication pioglitazone?

1. Weight loss

2. Bladder cancer

3. Heart failure exacerbation

4. Osteoporosis and increased fracture risk

The correct answer is: Weight loss

Weight loss is not a concern associated with pioglitazone; in fact, this medication is known to often lead to weight gain rather than loss. Pioglitazone is part of the thiazolidinedione class of drugs, which work by increasing insulin sensitivity. One of the common side effects of this medication is its potential to cause patients to retain fluid, contributing to weight gain. In contrast, the other issues listed are documented concerns when prescribing pioglitazone. Bladder cancer has been associated with long-term use of pioglitazone, leading to increased scrutiny in its usage and the necessity for patients to be monitored for potential malignancies during treatment. Heart failure exacerbation is also a well-known risk; pioglitazone can lead to fluid retention, which can worsen heart failure symptoms in susceptible individuals. Lastly, osteoporosis and increased fracture risk are additional considerations, particularly in older adults, as pioglitazone may affect bone density and contribute to fractures.