CANADIAN DIABETES EDUCATOR
EXAM 2025 QUESTIONS AND ANSWERS
Diagnosis of Diabetes (FPG, A1C, 2hPG in a 75g OFTT, random PG) - ANS FPG >/=7mmol/ml
A1c >/= 6.5%
2h PG in a 75g OGTT >/= 11mmol/L
random PG >/= 11.1mmol/L
Prediabetes (i.e. at high risk for developing diabetes) - A1C - ANS 6-6.4%
what medical conditions can cause A1C results to be misleading? - ANS -hemoglobinopathies
-iron deficiencies
-hemolytic anemia
-severe hepatic or renal disease
Impaired Fasting glucose (IFG) - ANS FPG - 6.1-6.9mmol/L
Impaired glucose tolerance (IGT) - ANS OGTT (w/ 75g of glucose) 7.8-11mmol/L
Screening for T1D is .... - ANS NOT recommended
Screening recommendations for T2D - ANS use FPG and/or A1c every 3 years in individuals
>/=40yo or in individuals at high risk (using risk calculator)
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,macrosomic infant - ANS infant that weighs over 8lbs at birth
microvascular complications - ANS retinopathy, neuropathy, nephropathy
macrovascular complications - ANS coronary, cerebrovascular, peripheral
Pharmacological therapies for PREVENTION of T2D (include by how much % it is reduced by) -
ANS 1. Metformin (~30%)
2. Acarbose (~30%)
3. Thiazolidinediones (~60%)
ACCORD, ADVANCE and VADT were the three major trials that concluded what? -
ANS intensive glycemic control - lowering A1C <6% resulted in higher mortality, severe
episodes of hypoglycemia - therefore targets should individualized!!
TARGET for A1C, FPG and RPG for MOST Diabetic (T1D and T2D) patients? - ANS A1c
<7mmol/L
FPG 4-7mmol/L
PPG 5-10mmol/L (5-8mmol/L if A1c target not achieved)
Who should have target of A1c <6.5% - ANS in T2D to further decrease risk of nephropathy
and retinopathy (ensure there is a balance so as not to cause HYPOGLYCEMIA)
Who should have target of 7.1-8.5% (7) - ANS 1. limited life expectancy
2. High level of functional dependency
3. severe coronary artery disease/ increased risk for ischemic events
4. multiple comorbidities
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,5. HX of recurrent severe hypoglycemic episodes
6. hypoglycemic unawareness
7. Long standing diabetes that is difficult to reduce A1c<7% - despite appropriate treatments
How and when should verification of the accuracy of SMBG monitors be done? What is the
acceptable difference? - ANS When: annually or when A1C results do not match
How: comparing FPG machine results with FPG from lab measurements
acceptable difference is 20%
If on insulin and planning exercise. What is the BG to watch out for to prevent HYPOglycemia?
What should be done if BG is at or past cut off? - ANS BG < 5.5mmol/L
Take 15-30g of carbs PRE-exercise
exercise recommendation for diabetes? - ANS 150min/week of moderate intensity aerobic
exercise spread over 3 days with no more than 2 days of sedentary
2-3 times per week of resistance training
How well can nutrition therapy reduce A1C? - ANS Can reduce A1C by 1-2%
carbohydrates recommendation - ANS no less than 130g/d (to maintain glucose to brain)
no less than 45% of energy (60% if high in fibre and low glycemic index)
Dietary fiber recommendation - ANS 25-38g for women
21-30g for men
>51yo w/ diabetes
Recommended added sugars intake? - ANS no more than 10% of total daily energy (aka. 50-
65g/day for a 2000-2600kcal/day diet)
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, Eating Well with Canada's Food Guide recommendation for fruit and veggies ? - ANS 7-10
servings / day
Recommendation for Fat intake? saturated fats? - ANS 20-35% of energy intake
saturated fats <7% of total daily
what type of fats are preferred? - ANS monounsaturated fats (MUFA)
polyunsaturated fats (PUFA)
long chain omega 3 FA
included up to 10% of total energy intake
Recommendation for proteins? - ANS 1-1.5g/kg body weight per day -15-20% of total energy
intake
What are dAGEs? Good / bad? - ANS dietary advanved glycation endpoints
BAD - increases markers for endothelial and adipocyte dysfunction and impairs vascular
function
Alcohol recommendations - ANS </=2 drinks per day OR <10 drinks per week for women
</= 3 drinks per day OR <15 drinks per week for men
main bad effect of alcohol - ANS HIDES and DELAYS hypoglycemia
Name the diets that can improve glycemic control (i.e. decreases A1c) (4) - ANS 1.
Mediterranean diet
2. vegan/vegetarian diet
3. incorporation of dietary pulses (beans, peas, chickpeas, lentils)
4 Copyright ©2025 THESTAR ALL RIGHTS RESERVED
EXAM 2025 QUESTIONS AND ANSWERS
Diagnosis of Diabetes (FPG, A1C, 2hPG in a 75g OFTT, random PG) - ANS FPG >/=7mmol/ml
A1c >/= 6.5%
2h PG in a 75g OGTT >/= 11mmol/L
random PG >/= 11.1mmol/L
Prediabetes (i.e. at high risk for developing diabetes) - A1C - ANS 6-6.4%
what medical conditions can cause A1C results to be misleading? - ANS -hemoglobinopathies
-iron deficiencies
-hemolytic anemia
-severe hepatic or renal disease
Impaired Fasting glucose (IFG) - ANS FPG - 6.1-6.9mmol/L
Impaired glucose tolerance (IGT) - ANS OGTT (w/ 75g of glucose) 7.8-11mmol/L
Screening for T1D is .... - ANS NOT recommended
Screening recommendations for T2D - ANS use FPG and/or A1c every 3 years in individuals
>/=40yo or in individuals at high risk (using risk calculator)
1 Copyright ©2025 THESTAR ALL RIGHTS RESERVED
,macrosomic infant - ANS infant that weighs over 8lbs at birth
microvascular complications - ANS retinopathy, neuropathy, nephropathy
macrovascular complications - ANS coronary, cerebrovascular, peripheral
Pharmacological therapies for PREVENTION of T2D (include by how much % it is reduced by) -
ANS 1. Metformin (~30%)
2. Acarbose (~30%)
3. Thiazolidinediones (~60%)
ACCORD, ADVANCE and VADT were the three major trials that concluded what? -
ANS intensive glycemic control - lowering A1C <6% resulted in higher mortality, severe
episodes of hypoglycemia - therefore targets should individualized!!
TARGET for A1C, FPG and RPG for MOST Diabetic (T1D and T2D) patients? - ANS A1c
<7mmol/L
FPG 4-7mmol/L
PPG 5-10mmol/L (5-8mmol/L if A1c target not achieved)
Who should have target of A1c <6.5% - ANS in T2D to further decrease risk of nephropathy
and retinopathy (ensure there is a balance so as not to cause HYPOGLYCEMIA)
Who should have target of 7.1-8.5% (7) - ANS 1. limited life expectancy
2. High level of functional dependency
3. severe coronary artery disease/ increased risk for ischemic events
4. multiple comorbidities
2 Copyright ©2025 THESTAR ALL RIGHTS RESERVED
,5. HX of recurrent severe hypoglycemic episodes
6. hypoglycemic unawareness
7. Long standing diabetes that is difficult to reduce A1c<7% - despite appropriate treatments
How and when should verification of the accuracy of SMBG monitors be done? What is the
acceptable difference? - ANS When: annually or when A1C results do not match
How: comparing FPG machine results with FPG from lab measurements
acceptable difference is 20%
If on insulin and planning exercise. What is the BG to watch out for to prevent HYPOglycemia?
What should be done if BG is at or past cut off? - ANS BG < 5.5mmol/L
Take 15-30g of carbs PRE-exercise
exercise recommendation for diabetes? - ANS 150min/week of moderate intensity aerobic
exercise spread over 3 days with no more than 2 days of sedentary
2-3 times per week of resistance training
How well can nutrition therapy reduce A1C? - ANS Can reduce A1C by 1-2%
carbohydrates recommendation - ANS no less than 130g/d (to maintain glucose to brain)
no less than 45% of energy (60% if high in fibre and low glycemic index)
Dietary fiber recommendation - ANS 25-38g for women
21-30g for men
>51yo w/ diabetes
Recommended added sugars intake? - ANS no more than 10% of total daily energy (aka. 50-
65g/day for a 2000-2600kcal/day diet)
3 Copyright ©2025 THESTAR ALL RIGHTS RESERVED
, Eating Well with Canada's Food Guide recommendation for fruit and veggies ? - ANS 7-10
servings / day
Recommendation for Fat intake? saturated fats? - ANS 20-35% of energy intake
saturated fats <7% of total daily
what type of fats are preferred? - ANS monounsaturated fats (MUFA)
polyunsaturated fats (PUFA)
long chain omega 3 FA
included up to 10% of total energy intake
Recommendation for proteins? - ANS 1-1.5g/kg body weight per day -15-20% of total energy
intake
What are dAGEs? Good / bad? - ANS dietary advanved glycation endpoints
BAD - increases markers for endothelial and adipocyte dysfunction and impairs vascular
function
Alcohol recommendations - ANS </=2 drinks per day OR <10 drinks per week for women
</= 3 drinks per day OR <15 drinks per week for men
main bad effect of alcohol - ANS HIDES and DELAYS hypoglycemia
Name the diets that can improve glycemic control (i.e. decreases A1c) (4) - ANS 1.
Mediterranean diet
2. vegan/vegetarian diet
3. incorporation of dietary pulses (beans, peas, chickpeas, lentils)
4 Copyright ©2025 THESTAR ALL RIGHTS RESERVED
