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