The Certified Diabetes Care and Education Specialist (CDCES) exam is a practice-based certification examination for experienced health professionals who provide diabetes care and education. Formerly known as the Certified Diabetes Educator (CDE) exam, the current certification covers diabetes prevention, prediabetes, diabetes management, self-management education, treatment, technology, complications, and professional practice. This guide covers current eligibility requirements, exam content, scoring, testing options, fees, and renewal information.
CDE Is Now CDCES
The credential formerly known as Certified Diabetes Educator (CDE) changed its name in 2020.
The current credential is:
Certified Diabetes Care and Education Specialist (CDCES)
The credential is administered by the Certification Board for Diabetes Care and Education (CBDCE), formerly known as the National Certification Board for Diabetes Educators (NCBDE).
The change reflects the broader role these professionals play in diabetes prevention, care, education, technology, treatment, behavioral support, and long-term disease management.
What Is a Certified Diabetes Care and Education Specialist?
A Certified Diabetes Care and Education Specialist is a health professional who has demonstrated specialized knowledge and experience in diabetes prevention, prediabetes, diabetes management, and diabetes care and education.
CDCES professionals help people affected by diabetes understand and manage their condition, make informed treatment decisions, use medications and technology safely, develop self-management skills, reduce risks, and work toward individualized health goals.
The certification is practice based. It is designed for experienced health professionals rather than people entering healthcare for the first time.
Who Is Eligible for the CDCES Exam?
Initial certification candidates must meet requirements involving their professional discipline, work experience, diabetes care and education experience, continuing education, and application.
1. Professional Discipline
You can qualify through one of several approved healthcare disciplines.
Licensed Professionals
You may qualify if you hold a current, active, unrestricted U.S. or U.S. territory license as a:
Clinical psychologist
Registered nurse, including nurse practitioners and clinical nurse specialists
Occupational therapist
Optometrist
Pharmacist
Physical therapist
Physician (MD or DO)
Podiatrist
Registered or Certified Professionals
You may also qualify with an applicable current registration or certification as a:
Registered dietitian or registered dietitian nutritionist through the Commission on Dietetic Registration
Physician assistant with active NCCPA certification
ACSM Certified Clinical Exercise Physiologist
Master Certified Health Education Specialist (MCHES)
A healthcare professional with at least a master’s degree in social work from an appropriately accredited U.S. college or university may also meet the discipline requirement.
2. Professional Practice Experience
You generally need at least two years of professional practice experience in the discipline under which you are applying.
Master’s degree waiver: If you have a master’s degree or higher in a health-related field, you may claim a one-year waiver of the two-year professional-practice requirement. This reduces the requirement to at least one year of professional practice in your discipline.
3. Diabetes Care and Education Experience
You must have at least 1,000 hours of diabetes care and education experience earned within the five years immediately before applying.
At least 200 of those hours must have been completed during the most recent year before your application.
The experience must involve the direct provision of diabetes care and education within the United States or its territories and must fall within the candidate’s professional scope of practice.
4. Continuing Education
You must complete at least 15 hours of continuing education applicable to diabetes during the two years immediately before applying.
The education must be provided or approved by an organization recognized under CBDCE’s continuing-education requirements.
Unique Qualifications Pathway
CBDCE also provides a Unique Qualifications (UQ) Pathway for certain health professionals who provide diabetes care and education but do not qualify under one of the standard listed disciplines.
The UQ pathway has its own education, professional experience, documentation, and approval requirements. Candidates using this route should complete the UQ approval process before applying for the certification exam.
CDCES Exam Format
The examination contains 175 multiple-choice questions. Of these, 150 are scored and 25 are unscored pretest questions.
The 25 pretest questions are being evaluated for possible future use. They are mixed throughout the examination and are not identified, so you should treat every question as though it contributes to your score.
What Is on the CDCES Exam?
The current examination content outline took effect July 1, 2024. The 150 scored questions are divided into three major categories.
| Content Area | Scored Questions |
|---|---|
| Assessment | 37 |
| Care and Education Interventions | 105 |
| Standards and Practices | 8 |
Assessment – 37 Questions
The Assessment category measures your ability to collect, interpret, and apply information about a person with diabetes or prediabetes.
| Assessment Area | Questions |
|---|---|
| Physical and Psychosocial | 12 |
| Self-Management Behaviors and Knowledge | 15 |
| Learning | 10 |
Physical and Psychosocial Assessment
Topics include diabetes-related health history, general health history, physical assessment, laboratory values, psychosocial wellbeing, social determinants of health, healthcare access, and factors that may affect diabetes self-management.
Self-Management Behaviors and Knowledge
You should understand how to assess a person’s current knowledge and practices involving:
The diabetes disease process
Eating habits and preferences
Physical activity
Medication use
Glucose and other monitoring
Use of diabetes technology and digital resources
Risk reduction and problem solving
Learning
The Learning section includes readiness to learn, health literacy, numeracy, digital literacy, learning preferences, developmental stage, language, culture, physical abilities, psychosocial factors, and barriers to successful education.
Care and Education Interventions – 105 Questions
This is by far the largest category on the exam, accounting for 105 of the 150 scored questions.
| Intervention Area | Questions |
|---|---|
| Disease Process and Approach to Treatment | 22 |
| Individualized Education Plan | 17 |
| Person-Centered Education on Self-Care Behaviors | 58 |
| Evaluation, Documentation, and Follow-Up | 8 |
Disease Process and Approach to Treatment – 22 Questions
Topics include diabetes diagnosis and classification, pathophysiology, modifiable and nonmodifiable risk factors, lifestyle management, medications, treatment goals, glucose metrics, blood pressure, lipids, quality of life, and risk reduction.
Individualized Education Plan – 17 Questions
You should understand how to develop a person-centered education plan based on assessment findings, collaborate with the individual and healthcare team, select appropriate instructional methods, and establish realistic and measurable goals.
Person-Centered Education on Self-Care Behaviors – 58 Questions
This is the largest single area on the CDCES exam.
Topics include:
Nutrition: meal planning, carbohydrates, fats, protein, alcohol, labels, weight management, supplements, and special nutritional considerations
Physical activity: recommendations, benefits, safety, exercise planning, and adjustments to food, medication, or monitoring
Medication management: medication classes, actions, administration, adverse effects, contraindications, selection, adjustment, insulin delivery systems, and immunizations
Monitoring: glucose, continuous glucose monitoring data, ketones, A1C, blood pressure, weight, lipids, and kidney health
Acute complications: hypoglycemia, hyperglycemia, diabetic ketoacidosis, and hyperosmolar hyperglycemic state
Chronic complications: eye disease, neuropathy, nephropathy, vascular disease, foot problems, infections, dental disease, and other diabetes-related comorbidities
Problem solving: illness, surgery, schedule changes, travel, emergencies, adaptive devices, and substance use
Living with diabetes: pregnancy, special populations, psychosocial health, transitions of care, safety, personal care, and social or financial considerations
Evaluation, Documentation, and Follow-Up – 8 Questions
This section covers evaluating whether interventions are working, measuring progress toward goals, revising care and education plans, documenting outcomes, communicating with the healthcare team, and arranging appropriate follow-up care and referrals.
Study priority: Care and Education Interventions represents 70% of the 150 scored questions. Within that category, Person-Centered Education on Self-Care Behaviors alone accounts for 58 questions.
Standards and Practices – 8 Questions
The final major category focuses on the professional standards and systems surrounding diabetes care and education.
You should understand:
National Standards for Diabetes Self-Management Education and Support
National Diabetes Prevention Program standards
Current professional and clinical practice standards
Population-health strategies
Team-based care and professional collaboration
Advocacy and access to diabetes care, medications, technology, and supplies
Diabetes prevention strategies
Evidence-based care and education
Health disparities and barriers to care
Principles of diversity, equity, and inclusion
How Much Does the CDCES Exam Cost?
The standard fee for an initial or expired-certification examination application is currently $350.
First-time candidates approved through the Unique Qualifications pathway currently pay a different initial application fee. Candidates using that pathway should confirm the amount during the application process.
How Do I Apply?
1. Confirm that you meet the discipline requirement.
Make sure your professional license, registration, certification, or other qualifying credential is current and meets CBDCE requirements.
2. Verify your professional experience.
Confirm that you have the required general professional-practice experience in your qualifying discipline.
3. Document your diabetes care and education experience.
You need 1,000 qualifying hours within the preceding five years, including at least 200 hours during the most recent year.
4. Complete your continuing education.
Earn at least 15 qualifying diabetes-related CE hours within the two years before applying.
5. Submit your application through CBDCE.
Create or sign in to your CBDCE account, complete the application, and pay the applicable fee.
6. Complete an audit if selected.
Some candidates are selected to provide supporting documentation before the application is approved.
7. Schedule your exam.
Once approved, you receive a 90-day eligibility window and can schedule through PSI.
When Is the CDCES Exam Offered?
The CDCES exam is offered year-round.
After your application is approved, CBDCE gives you a 90-day eligibility window. You must schedule and complete the exam during that period.
If you do not test before the window expires, you normally forfeit the application and fees and must reapply.
A one-time transfer to a new 90-day window is available for a $100 transfer fee when the request is made within the required deadline.
PSI Test Center or Live Remote Proctoring?
The CDCES exam can be taken through either a PSI Test Center or Live Remote Proctoring (LRP).
Take the computer-delivered examination at an authorized PSI testing location. A pencil and scratch paper are provided, and an on-screen calculator is available.
Take the examination from home using your own compatible computer, webcam, microphone, internet connection, and the PSI secure testing platform.
Remote-testing difference: Unscheduled breaks are not permitted during a Live Remote Proctoring session. At a test center, you may take a break, but the four-hour exam clock continues to run.
What to Know Before Test Day
Make sure the first and last name on your identification match your CBDCE exam registration.
Bring a current, valid government-issued photo ID that meets PSI requirements.
Use the on-screen calculator provided by the testing system when calculations are required.
At a PSI center, pencils and scratch paper are supplied for your use.
For remote testing, complete PSI’s computer compatibility check before your appointment and again shortly before test day.
Answer every question you can. There is no penalty for guessing.
Use the testing system’s bookmark feature to mark questions you want to review before submitting the exam.
How Is the CDCES Exam Scored?
CDCES exam scores are reported as both raw and scaled scores.
Your raw score is based on the number of scored questions you answer correctly. That result is converted to a scaled score from 0 to 99.
Passing score: 70. You must earn a scaled score of at least 70 to pass the CDCES examination.
The exact number of questions you need to answer correctly can vary between exam forms because CBDCE uses statistical equating to account for small differences in difficulty.
Your score report also provides raw performance information for the three major content categories. However, your overall pass or fail result is based on the total scaled score, not on passing each content category separately.
When Will I Get My Results?
You receive a pass or fail result on screen immediately after completing the examination.
For test-center candidates, PSI sends the official score report to the email address on record within approximately 24–48 hours.
Remote candidates also receive an on-screen result at the end of the session followed by an emailed score report.
What If I Don’t Pass?
There is no published lifetime limit on the number of CDCES exam attempts for unsuccessful candidates.
However, each new attempt requires you to:
Meet the eligibility requirements in effect when you reapply
Submit a new application
Pay the applicable examination fee again
How Long Does CDCES Certification Last?
The CDCES renewal cycle is currently undergoing an important transition.
Credentials Earned Through 2026
Current CDCES certification operates on a five-year certification cycle. Existing certificants transition to the new system according to when their current credential expires.
Beginning January 1, 2027
Anyone newly certified beginning January 1, 2027 will enter a three-year renewal cycle.
| Requirement | 5-Year Cycle | 3-Year Cycle |
|---|---|---|
| Renewal Period | 5 years | 3 years |
| Practice Requirement | 1,000 hours | 600 hours |
| Continuing Education | 75 hours | 45 hours |
Current CDCES holders should follow the transition schedule associated with their existing expiration date rather than assuming their present certification period has been shortened.
How Can I Prepare for the CDCES Exam?
The current exam is heavily weighted toward Care and Education Interventions. That category contains 105 of the 150 scored questions, so preparation should go well beyond memorizing diagnostic criteria or medication names.
You need to understand how diabetes knowledge is applied to realistic care, education, treatment, self-management, technology, and problem-solving situations.
CDCES Study Checklist
Use study materials aligned with the content outline effective July 1, 2024.
Review assessment of health status, psychosocial factors, social determinants of health, self-management behaviors, and learning needs.
Know diabetes classifications, pathophysiology, risk factors, treatment targets, and lifestyle interventions.
Review nutrition, physical activity, medication classes, insulin delivery, glucose monitoring, CGM, and other diabetes technologies.
Know the causes, prevention, recognition, and treatment of acute and chronic diabetes complications.
Practice developing individualized education plans and measurable goals based on assessment findings.
Review pregnancy, pediatrics, older adults, transitions of care, psychosocial issues, emergencies, travel, and other special situations.
Know current professional standards, diabetes prevention standards, team-based care, advocacy, health disparities, and evidence-based practice.
Practice evaluating interventions, documenting outcomes, and modifying care plans based on progress and changing needs.
Complete timed practice so you are comfortable managing 175 questions across a four-hour testing session.
CDCES Study Resources
Use these resources for additional review and practice for the current Certified Diabetes Care and Education Specialist exam.
CDCES® and Certified Diabetes Care and Education Specialist® are registered trademarks of the Certification Board for Diabetes Care and Education (CBDCE). CBDCE is not affiliated with StudyGuideZone or Mometrix Test Preparation and does not endorse these products or services.
