Certified Diabetes Educator Practice Exam

The drug class most associated with causing hypoglycemic symptoms is Meglitinides. These medications function by stimulating the pancreas to release more insulin in response to meals. Because their mechanism directly influences insulin secretion, there is a pronounced risk of causing low blood sugar, particularly if a person does not eat after taking the medication or if the dose is too high.

In contrast, the other options have different mechanisms of action and generally pose a lower risk for hypoglycemia. Biguanides, such as metformin, primarily work by reducing glucose production in the liver and improving insulin sensitivity, which does not lead to hypoglycemia on their own. DPP-4 inhibitors enhance incretin levels, which help regulate insulin and glucagon levels, and they typically have a neutral effect on blood sugar. TZDs, or thiazolidinediones, also focus on improving insulin sensitivity and have a very low risk of causing hypoglycemia unless used in conjunction with other insulin-secretagogue medications.

Therefore, the characteristics and mechanisms of action of Meglitinides make this class the most associated with hypoglycemic events among the options provided.