Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

A 42-year-old man with a high A1C despite good management strategies seeks to lose weight. What would be the best medication option for him?

1. Dapagliflozin

2. Glipizide

3. Pioglitazone

4. Glargine

The correct answer is: Dapagliflozin

Dapagliflozin is a sodium-glucose co-transporter 2 (SGLT2) inhibitor that helps in managing diabetes, particularly in individuals who are overweight or obese. This medication works by preventing glucose reabsorption in the kidneys, leading to increased glucose excretion in urine, which can help lower blood glucose levels and contribute to weight loss. In the context of this patient, who has a high A1C despite good management strategies and expresses a desire to lose weight, dapagliflozin is optimal. It not only aids in glycemic control but also supports weight management, making it a suitable choice for someone looking to improve their condition while addressing weight concerns. Other medications listed may not align as well with the patient's goals. For instance, glipizide is a sulfonylurea that can potentially cause weight gain, which contradicts the patient's intention to lose weight. Pioglitazone, a thiazolidinedione, may also lead to weight gain and fluid retention, which could be counterproductive for someone seeking to reduce their weight. Glargine, an insulin, is effective for blood sugar management but is also associated with weight gain due to the anabolic effects of insulin. Therefore, dapag