CDCES Exam 2025
how much of a plum would be 15 grams of carbs -
✅1 plum
Medicare DPP FBG Criteria -
✅110-125
CDC DPP FBG Criteria -
✅100-125
Which DPP program will NOT accept self reported blood sugars? -
✅Medicare DPP
Which DPP program will NOT accept patients with a history of ESRD or GDM? -
✅Medicare DPP
Which DPP program will NOT accept patients if they are currently pregnant? -
✅CDC DPP
Which medication can mask hypoglycemia symptoms? -
✅Beta Blockers
Simvastatin plus which medication can increase risk of myalgias? -
✅Gemfibrozil
What are the 8 risk factors for OSA? -
✅1. Age >60
2. African American (ONLY APPLIES if <35 yo)
3. Large neck
4. Heavy ETOH use
5. OTC decongestant use
6. Family history
7. Smoking
8. Male
Which lab value provides insight into short term glycemic outcomes and glucose excursions? -
✅1,5 AG
Which lab value will be inaccurate in advanced kidney or liver disease? -
✅1,5 AG
In patients with diabetes, who would qualify for ASA for primary prevention? -
✅age 50+ with 1+ additional risk factor
A1C goal in 2nd trimester -
1
, ✅<6%
For an emergency kit you should have: -
✅2 days of food + 3 days of water + 1 week of meds
Taking which med before bed (instead of before dinner) can help prevent nighttime
hypoglycemia and improve FBG? -
✅NPH
Low carb meal, increased activity, etoh, delayed/missed meals, insulin timing, too much meds
are all causes of: -
✅hypoglycemia
What are some ways to treat hypoglycemia? -
✅4-8 oz of sugary drink
handful of raisins
piece of fruit
4+ glucose tabs
glucose hel/honey
1 cup of milk
15+ skittles
Which hypoglycemia med is approved for all ages? -
✅Glucagon
Glucagon can be given via ___ -
✅SC or IM injection
Bolus insulin would lower -
✅Post prandial sugars
Basal insulin would lower -
✅FBG and in between meals
Name 2 types of bolus insulins -
✅Rapid LAG (lispro, aspart, glulisine)
Short (regular)
Name 2 types of basal insulins -
✅Intermediate (NPH)
Long "DDG" (degludec, detemir, glargine)
How to calculate estimated glucose? -
✅A1C 5 correlates to eGlucose of 97. For each additional A1C add +29.
What happens in Phase I (Fed State)? -
✅1. exogenous glucose is main source of glucose
2. increase insulin, decrease in glucagon
2
,3. insulin prevents glycogen breakdown
4. all tissues use glucose
5. excess glucose is stored as glycogen and TG
What happens in Phase II (post absorptive state)? -
✅1. insulin decrease, increase glucagon
2. glycogen breakdown is main source of glucose
3. hepatic gluconeogenesis also happens
4. adipose tissues break down TG into FFA
5. Glucose: used by all tissues except liver
What happens in Phase III (early starvation state)? -
✅1. some glycogen breakdown
2. but main source is hepatic gluconeogenesis
3. lactate provides 50% of gluconeogenesis substrate
4. AA, alanine, glycerol are other substrates
5. decrease insulin, increase counter-regulatory hormones (GH, cortisol, glucagon, epi)
6. Glucose: used by all tissues except liver
What happens in Phase IV (preliminary prolonged starvation)? -
✅1. renal + hepatic gluconeogenesis
2. brain: uses glucose > ketones
3. glucose: brain, RBC, renal medulla
4. increase counter-regulatory hormones
5. protein breakdown (catabolism) starts to happen because fat stores are depleted
What happens in Phase V (secondary prolonged starvation)? -
✅1. renal + hepatic gluconeogenesis
2. brain: uses ketones > glucose
3. glucose: used by brain, RBC, renal medulla
Phase I (Fed State) Timeline -
✅0-4 hours post meal
Phase II (post absorptive state) Timeline -
✅4-16 hours post meal
Phase III (early starvation state) timeline -
✅16-48 hours post meal
Phase IV (preliminary prolonged starvation) Timeline -
✅2-24 days
Phase V (secondary prolonged starvation) timeline -
✅24-40 days
Health and social conditions increase burden or disease on a community -
✅Syndemic
3
, #new cases/specific timeframe (Measures risk of people developing diabetes) -
✅Incidence
#people who already have diabetes -
✅Prevalence
focuses on clinical practice that integrates knowledge -
✅Clinical management and Integration
focuses on communication that is essential to optimize quality of care -
✅Communication and advocacy
identify ways to increase behavioral change, QOL, self management across lifespan -
✅person centered care and education across lifespan
identify research and quality improvement competencies essential to guide research and QI
activities -
✅research quality and improvement
systematic review of process and outcome data -
✅quality improvement
example: let's try to increase # of GDM patients in our program by 10% -
✅quality improvement
apply business principles, population health, systems practice to impact outcome of systems,
providers, populations -
✅systems wide practice
address competencies related to lifelong learning and professionalism -
✅professional practice
Help patients gain SKILLS, KNOWLEDGE, and BEHAVIORS to self manage their diabetes -
✅Goals of DSMES
When to refer to DSMES -
✅1. at diagnosis
2. annually
3. complicating factors (SDOH change)
4. life transition (new job/insurance/doctor)
Steps of DSMES program -
✅"AGPIE"
Assessment
Goal Setting
Planning
Implementation
Evaluation
4
how much of a plum would be 15 grams of carbs -
✅1 plum
Medicare DPP FBG Criteria -
✅110-125
CDC DPP FBG Criteria -
✅100-125
Which DPP program will NOT accept self reported blood sugars? -
✅Medicare DPP
Which DPP program will NOT accept patients with a history of ESRD or GDM? -
✅Medicare DPP
Which DPP program will NOT accept patients if they are currently pregnant? -
✅CDC DPP
Which medication can mask hypoglycemia symptoms? -
✅Beta Blockers
Simvastatin plus which medication can increase risk of myalgias? -
✅Gemfibrozil
What are the 8 risk factors for OSA? -
✅1. Age >60
2. African American (ONLY APPLIES if <35 yo)
3. Large neck
4. Heavy ETOH use
5. OTC decongestant use
6. Family history
7. Smoking
8. Male
Which lab value provides insight into short term glycemic outcomes and glucose excursions? -
✅1,5 AG
Which lab value will be inaccurate in advanced kidney or liver disease? -
✅1,5 AG
In patients with diabetes, who would qualify for ASA for primary prevention? -
✅age 50+ with 1+ additional risk factor
A1C goal in 2nd trimester -
1
, ✅<6%
For an emergency kit you should have: -
✅2 days of food + 3 days of water + 1 week of meds
Taking which med before bed (instead of before dinner) can help prevent nighttime
hypoglycemia and improve FBG? -
✅NPH
Low carb meal, increased activity, etoh, delayed/missed meals, insulin timing, too much meds
are all causes of: -
✅hypoglycemia
What are some ways to treat hypoglycemia? -
✅4-8 oz of sugary drink
handful of raisins
piece of fruit
4+ glucose tabs
glucose hel/honey
1 cup of milk
15+ skittles
Which hypoglycemia med is approved for all ages? -
✅Glucagon
Glucagon can be given via ___ -
✅SC or IM injection
Bolus insulin would lower -
✅Post prandial sugars
Basal insulin would lower -
✅FBG and in between meals
Name 2 types of bolus insulins -
✅Rapid LAG (lispro, aspart, glulisine)
Short (regular)
Name 2 types of basal insulins -
✅Intermediate (NPH)
Long "DDG" (degludec, detemir, glargine)
How to calculate estimated glucose? -
✅A1C 5 correlates to eGlucose of 97. For each additional A1C add +29.
What happens in Phase I (Fed State)? -
✅1. exogenous glucose is main source of glucose
2. increase insulin, decrease in glucagon
2
,3. insulin prevents glycogen breakdown
4. all tissues use glucose
5. excess glucose is stored as glycogen and TG
What happens in Phase II (post absorptive state)? -
✅1. insulin decrease, increase glucagon
2. glycogen breakdown is main source of glucose
3. hepatic gluconeogenesis also happens
4. adipose tissues break down TG into FFA
5. Glucose: used by all tissues except liver
What happens in Phase III (early starvation state)? -
✅1. some glycogen breakdown
2. but main source is hepatic gluconeogenesis
3. lactate provides 50% of gluconeogenesis substrate
4. AA, alanine, glycerol are other substrates
5. decrease insulin, increase counter-regulatory hormones (GH, cortisol, glucagon, epi)
6. Glucose: used by all tissues except liver
What happens in Phase IV (preliminary prolonged starvation)? -
✅1. renal + hepatic gluconeogenesis
2. brain: uses glucose > ketones
3. glucose: brain, RBC, renal medulla
4. increase counter-regulatory hormones
5. protein breakdown (catabolism) starts to happen because fat stores are depleted
What happens in Phase V (secondary prolonged starvation)? -
✅1. renal + hepatic gluconeogenesis
2. brain: uses ketones > glucose
3. glucose: used by brain, RBC, renal medulla
Phase I (Fed State) Timeline -
✅0-4 hours post meal
Phase II (post absorptive state) Timeline -
✅4-16 hours post meal
Phase III (early starvation state) timeline -
✅16-48 hours post meal
Phase IV (preliminary prolonged starvation) Timeline -
✅2-24 days
Phase V (secondary prolonged starvation) timeline -
✅24-40 days
Health and social conditions increase burden or disease on a community -
✅Syndemic
3
, #new cases/specific timeframe (Measures risk of people developing diabetes) -
✅Incidence
#people who already have diabetes -
✅Prevalence
focuses on clinical practice that integrates knowledge -
✅Clinical management and Integration
focuses on communication that is essential to optimize quality of care -
✅Communication and advocacy
identify ways to increase behavioral change, QOL, self management across lifespan -
✅person centered care and education across lifespan
identify research and quality improvement competencies essential to guide research and QI
activities -
✅research quality and improvement
systematic review of process and outcome data -
✅quality improvement
example: let's try to increase # of GDM patients in our program by 10% -
✅quality improvement
apply business principles, population health, systems practice to impact outcome of systems,
providers, populations -
✅systems wide practice
address competencies related to lifelong learning and professionalism -
✅professional practice
Help patients gain SKILLS, KNOWLEDGE, and BEHAVIORS to self manage their diabetes -
✅Goals of DSMES
When to refer to DSMES -
✅1. at diagnosis
2. annually
3. complicating factors (SDOH change)
4. life transition (new job/insurance/doctor)
Steps of DSMES program -
✅"AGPIE"
Assessment
Goal Setting
Planning
Implementation
Evaluation
4
