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CDCES Exam
CDCES Exam Questions and Answers
2024/2025
What are the components of good insulin injection technique?
Proper insulin injection technique includes injecting into appropriate body areas,
injection site rotation, appropriate care of injection sites to avoid infection or other
complications, and avoidance of intramuscular (IM) insulin delivery (64)
What are the treatment recommendations for type 1 diabetes?
9.1 Most people with type 1 diabetes should be treated with multiple daily injections
of prandial and basal insulin, or continuous subcutaneous insulin infusion. A
9.2 Most individuals with type 1 diabetes should use rapid-acting insulin analogs to reduce
hypoglycemia risk. A
9.3 Patients with type 1 diabetes should be trained to match prandial insulin doses to
carbohydrate intake, premeal blood glucose, and anticipated physical activity. (64)
What are the treatment recommendations for type 2 diabetes? What are the 4 reasons for
early introduction of insulin? How often should treatment be re-evaluated?
"When diet and exercise are no longer sufficient:
1) "Metformin is the preferred initial pharmacologic agent for the treatment of type 2
diabetes." (64)
2) "Once initiated, metformin should be continued as long as it is tolerated and not
contraindicated; other agents, including insulin, should be added to metformin." (64)
3. "Among patients with type 2 diabetes who have established atherosclerotic cardiovascular
disease or indicators of high risk, established kidney disease, or heart failure, a sodium-
glucose cotransporter 2 inhibitor or glucagon-like peptide 1 receptor agonist with
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demonstrated cardiovascular disease benefit is recommended as part of the glucose-lowering
regimen independent of A1C and in consideration of patient-specific factors. (i.e. liraglutide,
caniglifozin, empagliflozin)" (64)
4. "The early introduction of insulin should be considered if there is evidence of ongoing
catabolism (weight loss), if symptoms of hyperglycemia are present, or when A1C levels
(>10% [86 mmol/mol]) or blood glucose levels (≥300 mg/dL [16.7 mmol/L]) are very high."
(64)
5. "The medication regimen and medication-taking behavior should be reevaluated at regular
intervals (every 3-6 months) and adjusted as needed to incorporate specific factors that
impact choice of treatment" (64)
What are the types of long-acting insulin?
NPH, U-500 regular, Detemir, Glargine, U-300 Glargine and Degludec (12)
What are the types of short-acting insulin?
Afrezza, Fiasp, Apart, Glulisine, Lispro, U-200 Lispro, Human regular, U-500 regular
(12)
What hormones influence hepatic glucose production?
Cortisol, Growth hormone, Glucagon, Epi/ Norepi, Progesterone, Estrogen (12)
What are the advantages of continuous insulin infusion as compared to multiple daily
injections?
Ability to account for dawn phenomenon, implement temp basal rates, have variable
schedules, skip/delay meals without hypoglycemia (12)
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What supplies are needed for pump vacations or as a back up?
Injectable basal & bolus insulin, vial or pen, syringes/ pen needles, dosages, transition
plan back to pump (12)
What is the transtheoretical model?
An integrative framework for understanding how individuals and populations progress
toward adopting and maintaining health behaviour change. It recognizes that
behaviour occurs in steps, not all at once - precontemplation, contemplation,
preparation, action, maintenance, termination
What is the socio-ecological model?
The construct of health was broadly conceptualized in the SEM and focused on the
major contributors that might affect health. The SEM states that health is affected by
the interaction between the characteristics of the individual, the community, and the
environment that includes the physical, social, and political components. -
https://www.tandfonline.com/doi/full/10.1080/1059924X.2017.1358971
What is the health belief model?
The HBM derives from psychological and behavioral theory with the foundation that
the two components of health-related behavior are 1) the desire to avoid illness, or
conversely get well if already ill; and, 2) the belief that a specific health action will
prevent, or cure, illness. Ultimately, an individual's course of action often depends on
the person's perceptions of the benefits and barriers related to health behavior. -
https://sphweb.bumc.bu.edu/otlt/mph-
modules/sb/behavioralchangetheories/behavioralchangetheories2.html
What is self-efficacy?
This refers to the level of a person's confidence in his or her ability to successfully
perform a behavior. This construct was added to the model most recently in mid-1980.
Self-efficacy is a construct in many behavioral theories as it directly relates to whether
a person performs the desired behavior. - https://sphweb.bumc.bu.edu/otlt/mph-
modules/sb/behavioralchangetheories/behavioralchangetheories2.html
What is social learning theory (Bandura)?
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