Which of the following is a contraindication to the use of GLP-1 receptor agonists?

• A. Severe liver disease
• B. History of pancreatitis
• C. Medullary thyroid cancer or MEN
• D. Hypertension

Answer: (C)

GLP-1 receptor agonists are used to improve glycemic control in type 2 diabetes by enhancing incretin effects. A key safety signal with these agents is their association with thyroid C‑cell tumors in animal studies, which carries over into human labeling as a contraindication in patients with medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (MEN2). Because of this potential risk, medullary thyroid cancer or MEN2 makes using a GLP-1 receptor agonist inappropriate.

Other conditions listed, such as severe liver disease, a history of pancreatitis, or hypertension, are not absolute contraindications. Pancreatitis risk is monitored, and liver disease or high blood pressure may require caution or monitoring, but they do not by themselves bar use the way medullary thyroid carcinoma or MEN2 does.