Which medication is least likely to cause hypoglycemia but runs the risk of lactic acidosis?

Which medication is least likely to cause hypoglycemia but runs the risk of lactic acidosis?

• A. Metformin
• B. Sulfonylureas
• C. Acarbose
• D. Pioglitazone

Answer: (A)

Metformin lowers blood glucose without increasing insulin secretion, so it is unlikely to cause hypoglycemia on its own. Its standout adverse risk is lactic acidosis, a rare but serious condition that can occur when metformin accumulates in the body, especially with reduced kidney function, dehydration, heart failure, liver disease, or any situation causing tissue hypoxia. That combination of minimal hypoglycemia risk and a distinct lactic acidosis risk is characteristic of this drug class. Sulfonylureas stimulate pancreatic insulin release, which frequently leads to hypoglycemia, especially in older patients or when meals are skipped. Acarbose mainly slows carbohydrate absorption and has a low risk of hypoglycemia unless combined with other glucose-lowering agents, and it does not carry a notable lactic acidosis risk. Pioglitazone improves insulin sensitivity but does not typically cause hypoglycemia and isn’t associated with lactic acidosis; it has other risks like fluid retention and weight gain. So metformin best fits the scenario of being least likely to cause hypoglycemia while carrying a risk of lactic acidosis.

Metformin lowers blood glucose without increasing insulin secretion, so it is unlikely to cause hypoglycemia on its own. Its standout adverse risk is lactic acidosis, a rare but serious condition that can occur when metformin accumulates in the body, especially with reduced kidney function, dehydration, heart failure, liver disease, or any situation causing tissue hypoxia. That combination of minimal hypoglycemia risk and a distinct lactic acidosis risk is characteristic of this drug class.

Sulfonylureas stimulate pancreatic insulin release, which frequently leads to hypoglycemia, especially in older patients or when meals are skipped. Acarbose mainly slows carbohydrate absorption and has a low risk of hypoglycemia unless combined with other glucose-lowering agents, and it does not carry a notable lactic acidosis risk. Pioglitazone improves insulin sensitivity but does not typically cause hypoglycemia and isn’t associated with lactic acidosis; it has other risks like fluid retention and weight gain.

So metformin best fits the scenario of being least likely to cause hypoglycemia while carrying a risk of lactic acidosis.