Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

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Which medication is associated with a risk of bladder cancer in diabetes patients?

Metformin
Pioglitazone
Sitagliptin
Insulin

The correct answer is: Pioglitazone

Pioglitazone is associated with an increased risk of bladder cancer, particularly in individuals with diabetes. This link has been noted in various studies, prompting health authorities to assess the long-term safety of this medication. The potential mechanism may involve alterations in bladder function and cellular changes due to the activation of peroxisome proliferator-activated receptors (PPARs), which pioglitazone targets. As a result, healthcare providers often weigh the benefits of pioglitazone for glycemic control against its potential risks when considering treatment options for diabetes patients, especially those with a history of bladder cancer or at higher risk for developing it. Metformin, another widely used diabetes medication, does not have the same association with bladder cancer and is generally considered safe. Sitagliptin and insulin do not show significant