What to Study for the CDCES Exam: 2024 Content Outline

The Certification Examination for Diabetes Care and Education Specialists (CDCES) is offered by the Certification Board for Diabetes Care and Education (CBDCE). It’s built on an Examination Content Outline that took effect July 1, 2024, following CBDCE’s 2023 practice analysis.

CDCES Exam Format

The CDCES exam consists of 175 multiple-choice questions administered over a four-hour period. Of those, 150 are scored and count toward your result. The remaining 25 are pretest questions, included to determine how well they’ll perform before being used on the scored portion of the exam. They don’t affect your score, and they aren’t identified during the exam.

You can take the exam at a PSI test center or through Live Remote Online Proctoring.

How the Exam Is Weighted

  • I. Assessment — 25%, 37 questions
  • II. Care and Education Interventions — 70%, 105 questions
  • III. Standards and Practices — 5%, 8 questions

CDCES Examination Content Outline

CDCES Examination Content Outline (July 1, 2024)

I. Assessment — 37 questions

A. Physical and Psychosocial (12)

  • Diabetes-relevant health history (diagnosis, duration, symptoms, complications, treatment, comorbidities, healthcare utilization)
  • Diabetes-specific physical assessment (biometrics, site inspection, extremities, etc.)
  • Social determinants of health (economic, living situation, healthcare access, social supports, food/housing insecurity)
  • General health history (family, medical, mental health, substance use, surgical, allergies and medication)
  • Diabetes measures and other laboratory data
  • Mental health wellbeing (adjustment to diagnosis, coping ability, etc.)
  • Considerations related to diabetes self-care practices (cognitive, physical, language, cultural, spiritual, family/caregiver dynamics, fears and myths, life transitions, etc.)

B. Self-Management Behaviors and Knowledge (15)

  • Disease process
  • Eating habits and preferences
  • Activity habits and preferences
  • Medication practices and preferences (prescription, nonprescription, complementary and alternative medicine)
  • Monitoring and data collection (glucose, ketones, weight, dietary intake, activity, etc.)
  • Use of resources
  • Use of technology (monitors, smart delivery systems, apps, online education, patient portals, etc.)
  • Risk reduction of acute and chronic complications
  • Problem solving

C. Learning (10)

  • Goals and needs of learner
  • Readiness to learn and change behavior
  • Preferred learning styles (audio, visual, observational, psychomotor, individual vs. group, virtual, etc.)
  • Literacy, numeracy, health literacy, and digital literacy
  • Considerations related to learning (developmental stage, physical abilities, language preferences, cultural, spiritual, psychosocial, economic, family/caregiver dynamics, learning disabilities, etc.)

II. Care and Education Interventions — 105 questions

A. Disease Process and Approach to Treatment (22)

  • Diagnosis and classifications
  • Pathophysiology, including honeymoon period and dawn phenomenon
  • Modifiable and non-modifiable risk factors
  • Lifestyle management (activity, food, sleep, and stress)
  • Pharmacological approaches and options
  • Treatment goals (glycemic metrics, blood pressure, lipids, risk reduction, quality of life)

B. Individualized Education Plan (17)

  • Develop a plan based on assessment, in collaboration with the person with diabetes/pre-diabetes and the care team
  • Identify instructional methods
  • Set S.M.A.R.T. goals

C. Person-Centered Education on Self-Care Behaviors (58)

Nutrition principles and guidelines — ADA and Academy of Nutrition and Dietetics nutrition recommendations (meal planning, macro/micronutrients, dietary approaches); carbohydrates (types, food source, sugar alcohol and substitutes, carbohydrate counting); fats (types, food source); protein (food source, renal disease, wound care); alcohol (amount, precautions); food and medication integration (medication timing, meal timing); food label interpretation (nutrition facts, ingredients, health claims, sodium); weight management; dietary and herbal supplements; special considerations (food allergies, food aversion, gastroparesis, celiac disease, metabolic surgery, failure to thrive, disordered eating)

Physical activity — ADA and American College of Sports Medicine recommendations; benefits, challenges, and safety (comorbidities, post-exercise delayed onset hypoglycemia); activity plan (frequency, intensity, time, and types); adjustment of monitoring, food, and/or medication for planned and unplanned activities

Medication management — ADA/European Association for the Study of Diabetes (EASD) guidelines; medications (class, action, administration, side effects, contraindications); medication selection (cardiorenal protection, glycemic efficacy, impact on weight, types and duration of diabetes, cost, hypoglycemia risk); medication adjustment; insulin delivery systems; immunizations

Monitoring and interpretation — glucose (device selection, use, testing techniques, metrics); ketones; A1C; blood pressure; weight; lipids; kidney health; hepatic function

Acute complications: causes, prevention, and treatment — hypoglycemia and hypoglycemia unawareness; hyperglycemia; diabetic ketoacidosis (DKA); hyperosmolar hyperglycemic state (HHS)

Chronic complications and comorbidities: causes, prevention, and treatment — ADA clinical practice screening recommendations; eye disease (retinopathy, cataracts, glaucoma); sexual dysfunction; neuropathies; nephropathy; vascular disease (cerebral, cardiovascular, peripheral); lower extremity problems (ulcers, Charcot foot); dermatological (wounds, ulcers, site reactions); infection (genitourinary tract, pulmonary, skin and soft tissue); dental and gum disease; other comorbidities (depression, cognitive dysfunction, thyroid disease, celiac disease, obesity, sleep apnea, polycystic ovarian syndrome)

Problem solving — sick days; surgery and other procedures; changes in schedules (shift, religious, cultural); travel; emergency preparedness; assistive and adaptive devices (talking meter, magnifier); substance use (alcohol, tobacco, marijuana, caffeine)

Living with diabetes and prediabetes — life changes; transitions of care; special populations (pediatric, adolescence, geriatric, transplant); pre-conception planning, pregnancy, post-partum, and gestational diabetes; psychosocial wellbeing (depression, disordered eating, distress); role/responsibilities of care (individual, family, team); safety (sharps disposal, medical ID, driving); personal hygiene (dental, skin, feet); social/financial considerations (employment, insurance, disability, discrimination, school issues)

D. Evaluation, Documentation, and Follow-up (8)

  • Evaluate the effectiveness of interventions related to achievement and progress toward goals; self-management skills; psychosocial well-being; weight, eating habits, medications, and activity; and glycemic metrics
  • Revise, document, and communicate the individual’s plan for follow-up care, education, support, and referral

III. Standards and Practices — 8 questions

  • Describe the current National Standards for Diabetes Self-Management Education and Support (NSDSMES)
  • Describe the National Diabetes Prevention Program Standards (National DPP)
  • Apply practice standards (AACE, ADA, Endocrine Society, etc.)
  • Describe population health strategies
  • Collaborate with other healthcare professionals to advance team-based care
  • Advocate for people with diabetes (access to medications and supplies, care in institutional settings, policies, etc.)
  • Promote primary and secondary diabetes prevention strategies in at-risk individuals and populations
  • Promote evidence-based care and education
  • Recognize the impact of disparities (economic, access, gender, ethnicity, geographic, etc.)
  • Incorporate principles of diversity, equity, and inclusion

Pocket Prep’s CDCES practice questions are aligned to the July 1, 2024 Examination Content Outline. All of our practice questions are written by industry experts, and each question comes with a detailed explanation.