CDCES EXAM AND PRACTICE EXAM NEWEST 2026
TEST BANK| CERTIFIED DIABETES CARE & EDUCATION
SPECIALIST EXAM PREP 2026 WITH COMPLETE 450
REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) GRADED A+ (BRAND
NEW!!)
1. A 58-year-old patient with type 2 diabetes has an A1c of
8.2% on metformin 1000 mg BID and glipizide 10 mg BID. He
reports eating consistent meals but has morning fasting glucose
readings of 180-200 mg/dL. Which medication addition is most
appropriate to target fasting hyperglycemia?
A) Pioglitazone
B) Basal insulin (glargine)
C) DPP-4 inhibitor
D) SGLT2 inhibitor
1
,Answer: B
Rationale: Basal insulin is the most effective agent to lower
fasting glucose levels. Starting with 10 units or 0.1-0.2 units/kg
of glargine at bedtime is appropriate. Fasting hyperglycemia
indicates insufficient basal coverage .
2. A 45-year-old with type 2 diabetes and BMI of 32 kg/m² has
an A1c of 7.5% on metformin 1000 mg BID. She reports good
medication adherence but has a sedentary job and limited
physical activity. Which additional class of medication provides
the greatest weight loss benefit?
A) Sulfonylurea
B) GLP-1 receptor agonist
C) DPP-4 inhibitor
D) Thiazolidinedione
Answer: B
2
,Rationale: GLP-1 receptor agonists provide the greatest weight
loss among glucose-lowering medications (average 3-6 kg). They
also improve glycemic control and have cardiovascular benefits.
Sulfonylureas and TZDs cause weight gain .
3. A 62-year-old male with type 2 diabetes and established
ASCVD has an A1c of 7.8% on metformin 1000 mg BID and
glargine 30 units daily. Which class of medication should be
added for cardiovascular risk reduction regardless of A1c?
A) SGLT2 inhibitor
B) DPP-4 inhibitor
C) Sulfonylurea
D) TZD
Answer: A
Rationale: SGLT2 inhibitors have demonstrated cardiovascular
benefit in patients with type 2 diabetes and established ASCVD,
3
, including reduced MACE and heart failure hospitalizations. This
benefit is independent of baseline A1c .
4. A 68-year-old female with type 2 diabetes for 15 years,
eGFR 35 mL/min/1.73 m², and A1c 7.9% on metformin and
glipizide is unable to take metformin due to worsening kidney
function. Which medication requires dose adjustment at this
eGFR?
A) Glipizide
B) Sitagliptin
C) Empagliflozin
D) Pioglitazone
Answer: B
Rationale: Sitagliptin requires dose adjustment based on eGFR:
50% dose reduction when eGFR 30-45 (50 mg daily) and 75%
4
TEST BANK| CERTIFIED DIABETES CARE & EDUCATION
SPECIALIST EXAM PREP 2026 WITH COMPLETE 450
REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) GRADED A+ (BRAND
NEW!!)
1. A 58-year-old patient with type 2 diabetes has an A1c of
8.2% on metformin 1000 mg BID and glipizide 10 mg BID. He
reports eating consistent meals but has morning fasting glucose
readings of 180-200 mg/dL. Which medication addition is most
appropriate to target fasting hyperglycemia?
A) Pioglitazone
B) Basal insulin (glargine)
C) DPP-4 inhibitor
D) SGLT2 inhibitor
1
,Answer: B
Rationale: Basal insulin is the most effective agent to lower
fasting glucose levels. Starting with 10 units or 0.1-0.2 units/kg
of glargine at bedtime is appropriate. Fasting hyperglycemia
indicates insufficient basal coverage .
2. A 45-year-old with type 2 diabetes and BMI of 32 kg/m² has
an A1c of 7.5% on metformin 1000 mg BID. She reports good
medication adherence but has a sedentary job and limited
physical activity. Which additional class of medication provides
the greatest weight loss benefit?
A) Sulfonylurea
B) GLP-1 receptor agonist
C) DPP-4 inhibitor
D) Thiazolidinedione
Answer: B
2
,Rationale: GLP-1 receptor agonists provide the greatest weight
loss among glucose-lowering medications (average 3-6 kg). They
also improve glycemic control and have cardiovascular benefits.
Sulfonylureas and TZDs cause weight gain .
3. A 62-year-old male with type 2 diabetes and established
ASCVD has an A1c of 7.8% on metformin 1000 mg BID and
glargine 30 units daily. Which class of medication should be
added for cardiovascular risk reduction regardless of A1c?
A) SGLT2 inhibitor
B) DPP-4 inhibitor
C) Sulfonylurea
D) TZD
Answer: A
Rationale: SGLT2 inhibitors have demonstrated cardiovascular
benefit in patients with type 2 diabetes and established ASCVD,
3
, including reduced MACE and heart failure hospitalizations. This
benefit is independent of baseline A1c .
4. A 68-year-old female with type 2 diabetes for 15 years,
eGFR 35 mL/min/1.73 m², and A1c 7.9% on metformin and
glipizide is unable to take metformin due to worsening kidney
function. Which medication requires dose adjustment at this
eGFR?
A) Glipizide
B) Sitagliptin
C) Empagliflozin
D) Pioglitazone
Answer: B
Rationale: Sitagliptin requires dose adjustment based on eGFR:
50% dose reduction when eGFR 30-45 (50 mg daily) and 75%
4
