Certified Diabetes Educator (CDE) Certification
Exam Practice Test Questions And Correct
Answers (Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
(All major subject areas: pathophysiology, pharmacology, nutrition, lifestyle,
patient education, and clinical management)
1. The primary defect in type 2 diabetes mellitus is
A. Autoimmune destruction of pancreatic beta cells
B. Insulin resistance with relative insulin deficiency
C. Complete absence of insulin secretion
D. Defect in glucose transporters
Rationale: Type 2 diabetes is characterized by insulin resistance in
muscle and liver tissues, leading to a relative rather than absolute
insulin deficiency.
2. The HbA1c test reflects average plasma glucose levels over
approximately
A. 1 week
, B. 1 month
C. 2–3 months
D. 6 months
Rationale: HbA1c represents the average blood glucose over the
lifespan of red blood cells, about 120 days.
3. According to ADA recommendations, the target HbA1c for most
nonpregnant adults is
A. <5.5%
B. <6.0%
C. <7.0%
D. <8.5%
Rationale: The ADA recommends an HbA1c goal of <7% for most
adults to reduce microvascular complications.
4. Which of the following oral antidiabetic agents primarily increases
insulin secretion?
A. Metformin
B. Glipizide
C. Pioglitazone
D. Acarbose
Rationale: Sulfonylureas like glipizide stimulate pancreatic beta cells
to release insulin.
5. Which insulin has the fastest onset of action?
A. Regular insulin
, B. NPH insulin
C. Insulin lispro
D. Insulin detemir
Rationale: Rapid-acting insulins such as lispro begin acting within
10–15 minutes after injection.
6. Metformin primarily acts by
A. Stimulating insulin secretion
B. Decreasing hepatic glucose production
C. Increasing renal glucose excretion
D. Delaying carbohydrate absorption
Rationale: Metformin reduces hepatic gluconeogenesis and improves
insulin sensitivity.
7. Which of the following is a long-acting insulin?
A. Insulin lispro
B. NPH insulin
C. Insulin glargine
D. Regular insulin
Rationale: Glargine provides a basal insulin level with minimal peaks
lasting up to 24 hours.
8. The "rule of 15" is used to treat
A. Diabetic ketoacidosis
B. Hypoglycemia
C. Hyperglycemia
, D. Insulin resistance
Rationale: For mild hypoglycemia, 15 g of fast-acting carbohydrate is
given, and blood glucose is rechecked after 15 minutes.
9. A common gastrointestinal side effect of metformin is
A. Constipation
B. Abdominal pain without diarrhea
C. Diarrhea
D. Dry mouth
Rationale: Metformin commonly causes GI upset, especially diarrhea
and bloating when therapy begins.
10. A fasting plasma glucose of 126 mg/dL or higher on two
occasions indicates
A. Normal glucose tolerance
B. Impaired fasting glucose
C. Diabetes mellitus
D. Prediabetes
Rationale: The diagnostic threshold for diabetes is fasting plasma
glucose ≥126 mg/dL.
11. Which of the following is an incretin mimetic?
A. Glimepiride
B. Acarbose
C. Exenatide
Exam Practice Test Questions And Correct
Answers (Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
(All major subject areas: pathophysiology, pharmacology, nutrition, lifestyle,
patient education, and clinical management)
1. The primary defect in type 2 diabetes mellitus is
A. Autoimmune destruction of pancreatic beta cells
B. Insulin resistance with relative insulin deficiency
C. Complete absence of insulin secretion
D. Defect in glucose transporters
Rationale: Type 2 diabetes is characterized by insulin resistance in
muscle and liver tissues, leading to a relative rather than absolute
insulin deficiency.
2. The HbA1c test reflects average plasma glucose levels over
approximately
A. 1 week
, B. 1 month
C. 2–3 months
D. 6 months
Rationale: HbA1c represents the average blood glucose over the
lifespan of red blood cells, about 120 days.
3. According to ADA recommendations, the target HbA1c for most
nonpregnant adults is
A. <5.5%
B. <6.0%
C. <7.0%
D. <8.5%
Rationale: The ADA recommends an HbA1c goal of <7% for most
adults to reduce microvascular complications.
4. Which of the following oral antidiabetic agents primarily increases
insulin secretion?
A. Metformin
B. Glipizide
C. Pioglitazone
D. Acarbose
Rationale: Sulfonylureas like glipizide stimulate pancreatic beta cells
to release insulin.
5. Which insulin has the fastest onset of action?
A. Regular insulin
, B. NPH insulin
C. Insulin lispro
D. Insulin detemir
Rationale: Rapid-acting insulins such as lispro begin acting within
10–15 minutes after injection.
6. Metformin primarily acts by
A. Stimulating insulin secretion
B. Decreasing hepatic glucose production
C. Increasing renal glucose excretion
D. Delaying carbohydrate absorption
Rationale: Metformin reduces hepatic gluconeogenesis and improves
insulin sensitivity.
7. Which of the following is a long-acting insulin?
A. Insulin lispro
B. NPH insulin
C. Insulin glargine
D. Regular insulin
Rationale: Glargine provides a basal insulin level with minimal peaks
lasting up to 24 hours.
8. The "rule of 15" is used to treat
A. Diabetic ketoacidosis
B. Hypoglycemia
C. Hyperglycemia
, D. Insulin resistance
Rationale: For mild hypoglycemia, 15 g of fast-acting carbohydrate is
given, and blood glucose is rechecked after 15 minutes.
9. A common gastrointestinal side effect of metformin is
A. Constipation
B. Abdominal pain without diarrhea
C. Diarrhea
D. Dry mouth
Rationale: Metformin commonly causes GI upset, especially diarrhea
and bloating when therapy begins.
10. A fasting plasma glucose of 126 mg/dL or higher on two
occasions indicates
A. Normal glucose tolerance
B. Impaired fasting glucose
C. Diabetes mellitus
D. Prediabetes
Rationale: The diagnostic threshold for diabetes is fasting plasma
glucose ≥126 mg/dL.
11. Which of the following is an incretin mimetic?
A. Glimepiride
B. Acarbose
C. Exenatide
