Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

For a patient with type 2 diabetes who is concerned about hypoglycemia while wanting to lose weight, which medication would be the most appropriate choice?

1. Sitagliptin

2. Empagliflozin

3. Glargine insulin

4. Glulisine insulin

The correct answer is: Empagliflozin

The most appropriate choice for a patient with type 2 diabetes who is concerned about hypoglycemia while wanting to lose weight is empagliflozin. This medication belongs to the class of sodium-glucose cotransporter-2 (SGLT2) inhibitors, which work by preventing the reabsorption of glucose in the kidneys, leading to increased glucose excretion in urine. One of the key advantages of empagliflozin is its low risk of causing hypoglycemia when used alone, as it primarily relies on the presence of glucose to exert its effect. This makes it a safer option for patients worried about experiencing low blood sugar episodes. Additionally, SGLT2 inhibitors have been associated with weight loss, which aligns with the patient's goal of losing weight. In contrast, the other medications considered do not offer the same benefits in terms of weight loss or hypoglycemia risk. For instance, insulin therapies, such as glargine and glulisine, typically increase the risk of hypoglycemia and may also lead to weight gain. Sitagliptin, while having a lower risk of hypoglycemia compared to insulin, may not contribute to weight loss to the same extent as empagliflozin. Thus