<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 56-year-old man with type 2 diabetes mellitus comes to the physician for a follow-up examination. Three months ago, the patient was started on metformin therapy after counseling on diet, exercise, and weight reduction failed to reduce his hyperglycemia. Physical examination shows no abnormalities. His hemoglobin A1c is 8.4. Pioglitazone is added to the patients medication regimen. Which of the following cellular changes is most likely to occur in response to this new drug?? A: Decreased breakdown of glucagon-like peptide 1, B: Decreased sodium-dependent glucose cotransport, C: Depolarization of pancreatic β-cells, D: Autophosphorylation of receptor tyrosine kinase, E: Increased transcription of adipokines,  <response>: This is a medical question asking about the cellular changes that are most likely to occur in response to adding pioglitazone to a patients medication regimen for type 2 diabetes mellitus. Pioglitazone is a thiazolidinedione drug that acts as an insulin sensitizer by activating PPAR-gamma receptors in adipose tissue, skeletal muscle and liver. This leads to increased transcription of genes involved in glucose and lipid metabolism. The key here is recognizing that pioglitazone works by activating PPAR-gamma receptors, which then leads to increased transcription of certain genes. So the cellular change that is most directly caused by pioglitazone is increased transcription.Analyzing the choices, option E Increased transcription of adipokines is the best match, as adipokines are proteins secreted by adipose tissue that play a role in glucose and lipid metabolism. The other options describe changes that may occur downstream but are not the most direct cellular effect of pioglitazone.E: Increased transcription of adipokines 