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