Certified Diabetes Educator Examination questions
with verified answers
Ans✓✓✓ Bolus insulin may be initiated using a stepwise approach
(starting with 1 injection at 1 meal and additional mealtime injections
as needed) to achieve similar A1C reduction with lower hypoglycemia
risk compared to initiating bolus injections at every meal
A1C target for pregnant women with preexisting diabetes? Ans✓✓✓
Aim for an A1C of ≤6.5% during pregnancy (≤6.1% if possible), if can be
achieved safely, to lower the risk of late stillbirth and infant death.
A1C targets for adults that are more frail? Ans✓✓✓ a. Functionally
dependent: 7.1-8.0%
b. Frail and/or with dementia: 7.1-8.5%
c. End of life: A1C measurement not recommended. Avoid symptomatic
hyperglycemia and any hypoglycemia.
After what age should individuals be assessed before starting vigorous
or prolonged exercise? Ans✓✓✓ After 40 years of age.
They should have some testing done such as an ECG, Stress test etc.
,Are adjunctive wound therapies recommended? Ans✓✓✓ Insufficient
evidence to recommend i.e topical growth factor, granulocyte ulcers
At diagnosis , if A1C > or equal to 1.5% above target, then what should
next steps be if there is metabolic decompensation? Ans✓✓✓
Individuals with metabolic decompensation (e.g. marked
hyperglycemia, ketosis or unintentional weight loss) should receive
insulin with or without metformin, until glycemic control is achieved OR
type of diabetes is established
At diagnosis , if A1C > or equal to 1.5% above target, then what should
next steps be? Ans✓✓✓ If A1C values are > or equal to 1.5% above
target (without metabolic decompensation), initiating metformin in
combination with a second antihyperglycemic agent should be
considered to increase the likelihood of reaching target for SGLT2i, for
DPP4i
At diagnosis, if A1C <1.5 % above target what is the next action?
What about at the 3 months follow up? Ans✓✓✓ Healthy behaviour
interventions should be initiated at type 2 diabetes diagnosis and
reinforced and maintained throughout. Metformin may be introduced
at the time of diagnosis, in conjunction with healthy behaviour
interventions.
If glycemic targets are not achieved within 3 months using healthy
behaviour interventions alone, antihyperglycemic therapy should be
added to reduce the risk of microvascular complications . Metformin
should usually be selected before other agents due to its low risk of
,hypoglycemia and weight gain,and long-term experience with this
agent
B.G targets for pregnant women with pre-existing diabetes? Ans✓✓✓
Strive for target BG values:
i. Fasting and preprandial <5.3 mmol/L
ii. 1 hour postprandial <7.8 mmol/L
iii. 2 hours postprandial <6.7 mmol/L
Can insulin pumps be used during labor and delivery? Ans✓✓✓ CSII
(insulin pump) may be continued in women with pre-existing diabetes
during labour and delivery if the women or their partners can
independently and safely manage the insulin pump and they choose to
stay on the pump during labour and delivery.
Can Metformin be used in pregnancy? Ans✓✓✓ It does cross the
placenta barrier.
But long-term follow up from 18 months to 2 years indicate that
metformin exposure in-utero does not seem to be harmful with regards
to early motor, linguistic, social, metabolic and neurodevelopmental.
however, women should be informed that metformin crosses the
placenta, longer-term studies are not yet available, and the addition of
insulin is necessary in approximately 40% to achieve adequate glycemic
contro
, Client has T2D with clinical CVD and glycemic targets are not being met.
EGFr is > 30, what other anti diabetic medication should be added?
Ans✓✓✓ -Empagliflozin (Jardiance)
-Liraglutide (Victoza)
-Canafligozin (Invokana)
Definition of Diabetes Ans✓✓✓ 1) Defective insulin secretion (slowly
declining B cell function with T2D or quick autoimmune destruction of B
cells with T1D)
2)Defective insulin action (most commonly insulin resistance due to
obesity but also from pregnancy or other factors)
3) Combo of both
Diagnostic parameters of T2D? Ans✓✓✓ Fasting Plasma Glucose (FPG)-
> or equal to 7.0 mmol/L
A1C (adults)- > or equal to 6.5%
2hrPG in a 75 g OGTT- > or equal to 11.1 mmol/L
Random Plasma Glucose- > or equal to 11.1 mmol/L
-If there are no symptoms of hyperglycemia , TWO tests are needed
-If symptomatic then only one test is needed
Difference between High GI foods and Low GI foods? Ans✓✓✓ High GI
foods are more quickly digested which spikes the blood glucose, while
with verified answers
Ans✓✓✓ Bolus insulin may be initiated using a stepwise approach
(starting with 1 injection at 1 meal and additional mealtime injections
as needed) to achieve similar A1C reduction with lower hypoglycemia
risk compared to initiating bolus injections at every meal
A1C target for pregnant women with preexisting diabetes? Ans✓✓✓
Aim for an A1C of ≤6.5% during pregnancy (≤6.1% if possible), if can be
achieved safely, to lower the risk of late stillbirth and infant death.
A1C targets for adults that are more frail? Ans✓✓✓ a. Functionally
dependent: 7.1-8.0%
b. Frail and/or with dementia: 7.1-8.5%
c. End of life: A1C measurement not recommended. Avoid symptomatic
hyperglycemia and any hypoglycemia.
After what age should individuals be assessed before starting vigorous
or prolonged exercise? Ans✓✓✓ After 40 years of age.
They should have some testing done such as an ECG, Stress test etc.
,Are adjunctive wound therapies recommended? Ans✓✓✓ Insufficient
evidence to recommend i.e topical growth factor, granulocyte ulcers
At diagnosis , if A1C > or equal to 1.5% above target, then what should
next steps be if there is metabolic decompensation? Ans✓✓✓
Individuals with metabolic decompensation (e.g. marked
hyperglycemia, ketosis or unintentional weight loss) should receive
insulin with or without metformin, until glycemic control is achieved OR
type of diabetes is established
At diagnosis , if A1C > or equal to 1.5% above target, then what should
next steps be? Ans✓✓✓ If A1C values are > or equal to 1.5% above
target (without metabolic decompensation), initiating metformin in
combination with a second antihyperglycemic agent should be
considered to increase the likelihood of reaching target for SGLT2i, for
DPP4i
At diagnosis, if A1C <1.5 % above target what is the next action?
What about at the 3 months follow up? Ans✓✓✓ Healthy behaviour
interventions should be initiated at type 2 diabetes diagnosis and
reinforced and maintained throughout. Metformin may be introduced
at the time of diagnosis, in conjunction with healthy behaviour
interventions.
If glycemic targets are not achieved within 3 months using healthy
behaviour interventions alone, antihyperglycemic therapy should be
added to reduce the risk of microvascular complications . Metformin
should usually be selected before other agents due to its low risk of
,hypoglycemia and weight gain,and long-term experience with this
agent
B.G targets for pregnant women with pre-existing diabetes? Ans✓✓✓
Strive for target BG values:
i. Fasting and preprandial <5.3 mmol/L
ii. 1 hour postprandial <7.8 mmol/L
iii. 2 hours postprandial <6.7 mmol/L
Can insulin pumps be used during labor and delivery? Ans✓✓✓ CSII
(insulin pump) may be continued in women with pre-existing diabetes
during labour and delivery if the women or their partners can
independently and safely manage the insulin pump and they choose to
stay on the pump during labour and delivery.
Can Metformin be used in pregnancy? Ans✓✓✓ It does cross the
placenta barrier.
But long-term follow up from 18 months to 2 years indicate that
metformin exposure in-utero does not seem to be harmful with regards
to early motor, linguistic, social, metabolic and neurodevelopmental.
however, women should be informed that metformin crosses the
placenta, longer-term studies are not yet available, and the addition of
insulin is necessary in approximately 40% to achieve adequate glycemic
contro
, Client has T2D with clinical CVD and glycemic targets are not being met.
EGFr is > 30, what other anti diabetic medication should be added?
Ans✓✓✓ -Empagliflozin (Jardiance)
-Liraglutide (Victoza)
-Canafligozin (Invokana)
Definition of Diabetes Ans✓✓✓ 1) Defective insulin secretion (slowly
declining B cell function with T2D or quick autoimmune destruction of B
cells with T1D)
2)Defective insulin action (most commonly insulin resistance due to
obesity but also from pregnancy or other factors)
3) Combo of both
Diagnostic parameters of T2D? Ans✓✓✓ Fasting Plasma Glucose (FPG)-
> or equal to 7.0 mmol/L
A1C (adults)- > or equal to 6.5%
2hrPG in a 75 g OGTT- > or equal to 11.1 mmol/L
Random Plasma Glucose- > or equal to 11.1 mmol/L
-If there are no symptoms of hyperglycemia , TWO tests are needed
-If symptomatic then only one test is needed
Difference between High GI foods and Low GI foods? Ans✓✓✓ High GI
foods are more quickly digested which spikes the blood glucose, while
