Specialist Diabetes Educator Certification
(CDCES®) 2025/2026ACTUAL Exam ALREADY
GRADED A+
About the CDCES® Exam
The Certified Diabetes Care and Education Specialist (CDCES®) exam is administered by the
Certification Board for Diabetes Care and Education (CBDCE). The exam consists of 200
multiplechoice questions (150 scored + 25 pretest) with a 4-hour time limit. The exam blueprint
covers three major domains:
Domain
I. Assessment
II. Care and Education Intervention
III. Standards and Practices Approx. %
DOMAIN I: ASSESSMENT (Questions 1–50) 25%
70%
Section A: Physical and Psychosocial Assessment 5%
Question 1
According to the ADA Standards of Care, at what age should screening for prediabetes and type
2 diabetes begin for asymptomatic adults?
A. Age 25
B. Age 35
C. Age 45
D. Age 50
1
, Answer: B. Age 35
Rationale: The ADA recommends screening all asymptomatic adults for prediabetes and type 2
diabetes beginning at age 35, regardless of risk factors. Screening should be considered at any
age with overweight/obesity (BMI ≥ 25 kg/m² or ≥ 23 kg/m² in Asian Americans) and one or
more additional risk factors.
Question 2
Which of the following laboratory values confirms a diagnosis of diabetes?
A. Fasting plasma glucose ≥ 100 mg/dL
B. Fasting plasma glucose ≥ 126 mg/dL
C. Hemoglobin A1C ≥ 6.0%
D. Random plasma glucose ≥ 140 mg/dL
Answer: B. Fasting plasma glucose ≥ 126 mg/dL
Rationale: The ADA diagnostic criteria for diabetes include: (1) FPG ≥ 126 mg/dL after fasting ≥ 8
hours; (2) 2-hour plasma glucose ≥ 200 mg/dL during OGTT; (3) A1C ≥ 6.5%; or (4) random
plasma glucose ≥ 200 mg/dL with classic symptoms. FPG ≥ 100 mg/dL indicates prediabetes.
Question 3
A patient with type 1 diabetes presents with nausea, vomiting, abdominal pain, and fruity odor
on the breath. The patient's blood glucose is 450 mg/dL. Which condition is the patient MOST
likely experiencing?
A. Hyperosmolar hyperglycemic state (HHS)
B. Diabetic ketoacidosis (DKA)
C. Hypoglycemia
D. Lactic acidosis
Answer: B. Diabetic ketoacidosis (DKA)
Rationale: DKA is characterized by hyperglycemia (> 250 mg/dL), ketosis, metabolic acidosis, and
classic symptoms including nausea, vomiting, abdominal pain, and fruity/acetone breath odor
(from ketone production). DKA occurs primarily in type 1 diabetes due to absolute insulin
deficiency.
2
, Question 4
A patient with type 2 diabetes presents with profound dehydration, mental status changes, and
blood glucose of 850 mg/dL without significant ketosis. This presentation is MOST consistent
with:
A. Diabetic ketoacidosis (DKA)
B. Hyperosmolar hyperglycemic state (HHS)
C. Hypoglycemia
D. Lactic acidosis
Answer: B. Hyperosmolar hyperglycemic state (HHS)
Rationale: HHS is characterized by severe hyperglycemia (> 600 mg/dL), profound dehydration,
and altered mental status without significant ketosis or acidosis. It occurs more commonly in
type 2 diabetes and has a higher mortality rate than DKA.
Question 5
Which of the following is a microvascular complication of diabetes?
A. Retinopathy
B. Coronary artery disease
C. Cerebrovascular disease
D. Peripheral arterial disease
Answer: A. Retinopathy
Rationale: Microvascular complications of diabetes include retinopathy, nephropathy, and
neuropathy. Macrovascular complications include coronary artery disease, cerebrovascular
disease, and peripheral arterial disease.
Question 6
The "dawn phenomenon" in diabetes is characterized by:
A. Hypoglycemia in the early morning hours
B. Hyperglycemia in the early morning hours due to increased counterregulatory hormones
C. Hyperglycemia after the evening meal
D. Hypoglycemia after exercise
3
, Answer: B. Hyperglycemia in the early morning hours due to increased counterregulatory
hormones
Rationale: The dawn phenomenon is the early morning rise in blood glucose (typically between
4:00–8:00 AM) caused by the normal overnight surge of counterregulatory hormones (growth
hormone, cortisol, glucagon). It must be distinguished from the Somogyi effect.
Question 7
A patient with diabetes reports episodes of hypoglycemia in the early morning hours followed
by hyperglycemia upon waking. This pattern is MOST consistent with:
A. Dawn phenomenon
B. Somogyi effect
C. Insulin resistance
D. Gastroparesis
Answer: B. Somogyi effect
Rationale: The Somogyi effect is rebound hyperglycemia following nocturnal hypoglycemia. The
body releases counterregulatory hormones in response to hypoglycemia, causing a rebound rise
in blood glucose. Management involves reducing evening insulin doses.
Question 8
Which of the following is a sign or symptom of hypoglycemia?
A. Polyuria
B. Polydipsia
C. Diaphoresis
D. Polyphagia
Answer: C. Diaphoresis
Rationale: Signs and symptoms of hypoglycemia (blood glucose < 70 mg/dL) include diaphoresis,
tremors, palpitations, hunger, confusion, irritability, and in severe cases, loss of consciousness.
Polyuria, polydipsia, and polyphagia are classic symptoms of hyperglycemia.
Question 9
4
(CDCES®) 2025/2026ACTUAL Exam ALREADY
GRADED A+
About the CDCES® Exam
The Certified Diabetes Care and Education Specialist (CDCES®) exam is administered by the
Certification Board for Diabetes Care and Education (CBDCE). The exam consists of 200
multiplechoice questions (150 scored + 25 pretest) with a 4-hour time limit. The exam blueprint
covers three major domains:
Domain
I. Assessment
II. Care and Education Intervention
III. Standards and Practices Approx. %
DOMAIN I: ASSESSMENT (Questions 1–50) 25%
70%
Section A: Physical and Psychosocial Assessment 5%
Question 1
According to the ADA Standards of Care, at what age should screening for prediabetes and type
2 diabetes begin for asymptomatic adults?
A. Age 25
B. Age 35
C. Age 45
D. Age 50
1
, Answer: B. Age 35
Rationale: The ADA recommends screening all asymptomatic adults for prediabetes and type 2
diabetes beginning at age 35, regardless of risk factors. Screening should be considered at any
age with overweight/obesity (BMI ≥ 25 kg/m² or ≥ 23 kg/m² in Asian Americans) and one or
more additional risk factors.
Question 2
Which of the following laboratory values confirms a diagnosis of diabetes?
A. Fasting plasma glucose ≥ 100 mg/dL
B. Fasting plasma glucose ≥ 126 mg/dL
C. Hemoglobin A1C ≥ 6.0%
D. Random plasma glucose ≥ 140 mg/dL
Answer: B. Fasting plasma glucose ≥ 126 mg/dL
Rationale: The ADA diagnostic criteria for diabetes include: (1) FPG ≥ 126 mg/dL after fasting ≥ 8
hours; (2) 2-hour plasma glucose ≥ 200 mg/dL during OGTT; (3) A1C ≥ 6.5%; or (4) random
plasma glucose ≥ 200 mg/dL with classic symptoms. FPG ≥ 100 mg/dL indicates prediabetes.
Question 3
A patient with type 1 diabetes presents with nausea, vomiting, abdominal pain, and fruity odor
on the breath. The patient's blood glucose is 450 mg/dL. Which condition is the patient MOST
likely experiencing?
A. Hyperosmolar hyperglycemic state (HHS)
B. Diabetic ketoacidosis (DKA)
C. Hypoglycemia
D. Lactic acidosis
Answer: B. Diabetic ketoacidosis (DKA)
Rationale: DKA is characterized by hyperglycemia (> 250 mg/dL), ketosis, metabolic acidosis, and
classic symptoms including nausea, vomiting, abdominal pain, and fruity/acetone breath odor
(from ketone production). DKA occurs primarily in type 1 diabetes due to absolute insulin
deficiency.
2
, Question 4
A patient with type 2 diabetes presents with profound dehydration, mental status changes, and
blood glucose of 850 mg/dL without significant ketosis. This presentation is MOST consistent
with:
A. Diabetic ketoacidosis (DKA)
B. Hyperosmolar hyperglycemic state (HHS)
C. Hypoglycemia
D. Lactic acidosis
Answer: B. Hyperosmolar hyperglycemic state (HHS)
Rationale: HHS is characterized by severe hyperglycemia (> 600 mg/dL), profound dehydration,
and altered mental status without significant ketosis or acidosis. It occurs more commonly in
type 2 diabetes and has a higher mortality rate than DKA.
Question 5
Which of the following is a microvascular complication of diabetes?
A. Retinopathy
B. Coronary artery disease
C. Cerebrovascular disease
D. Peripheral arterial disease
Answer: A. Retinopathy
Rationale: Microvascular complications of diabetes include retinopathy, nephropathy, and
neuropathy. Macrovascular complications include coronary artery disease, cerebrovascular
disease, and peripheral arterial disease.
Question 6
The "dawn phenomenon" in diabetes is characterized by:
A. Hypoglycemia in the early morning hours
B. Hyperglycemia in the early morning hours due to increased counterregulatory hormones
C. Hyperglycemia after the evening meal
D. Hypoglycemia after exercise
3
, Answer: B. Hyperglycemia in the early morning hours due to increased counterregulatory
hormones
Rationale: The dawn phenomenon is the early morning rise in blood glucose (typically between
4:00–8:00 AM) caused by the normal overnight surge of counterregulatory hormones (growth
hormone, cortisol, glucagon). It must be distinguished from the Somogyi effect.
Question 7
A patient with diabetes reports episodes of hypoglycemia in the early morning hours followed
by hyperglycemia upon waking. This pattern is MOST consistent with:
A. Dawn phenomenon
B. Somogyi effect
C. Insulin resistance
D. Gastroparesis
Answer: B. Somogyi effect
Rationale: The Somogyi effect is rebound hyperglycemia following nocturnal hypoglycemia. The
body releases counterregulatory hormones in response to hypoglycemia, causing a rebound rise
in blood glucose. Management involves reducing evening insulin doses.
Question 8
Which of the following is a sign or symptom of hypoglycemia?
A. Polyuria
B. Polydipsia
C. Diaphoresis
D. Polyphagia
Answer: C. Diaphoresis
Rationale: Signs and symptoms of hypoglycemia (blood glucose < 70 mg/dL) include diaphoresis,
tremors, palpitations, hunger, confusion, irritability, and in severe cases, loss of consciousness.
Polyuria, polydipsia, and polyphagia are classic symptoms of hyperglycemia.
Question 9
4
