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Diabetes
CDCES Credential
Achieve the Most Recognized Credential in Diabetes Care and Education
Earning the Certified Diabetes Care and Education Specialist (CDCES) credential showcases your hard-earned diabetes knowledge and skills and can help you expand your professional opportunities!
What is a CDCES?
A CDCES, formerly known as a Certified Diabetes Educator or CDE, is a health professional who has comprehensive knowledge of and experience in diabetes prevention, prediabetes, and diabetes management. The CDCES credential is held by Registered Dietitian Nutritionists (RDNs), Registered Nurses, PAs, NPs, PharmDs, MDs, and other health professionals who participate on the diabetes care and education team.
What does a CDCES do?
A CDCES partners with people with diabetes to educate, support, and help them achieve their goals in managing diabetes.
What are the benefits of CDCES Certification?
The CDCES credential is a professionally recognized achievement and a sought-after mark of excellence in the diabetes community!
Obtaining certification will:
- Demonstrate your diabetes care and education skills and expertise
- Expand your career opportunities and increase marketability
- Provide you with credibility and recognition on the diabetes care team, and
- Help optimize outcomes for people with diabetes
Achieving CDCES certification shows people with diabetes, primary care providers, peers, and your employer that you are a dedicated professional with an enduring commitment to continual learning and high-quality patient care.
Earning the CDCES Credential
To earn the CDCES credential, health professionals go through a rigorous process, including passing an examination that covers numerous aspects of diabetes care and management. Click here to review the most common CDCES Program FAQs.
What are the eligibility requirements?
- Discipline: PAs meet the discipline requirement. Please see the Exam Handbook for additional qualifying disciplines. *
- Professional practice experience (work or volunteer):
- General: 2 years
- Diabetes education: 1,000 hours – within a maximum of 5 years (with 200 of those hours in the last 12 months)
- Continuing education (CE) activities: 15 hours of diabetes-related CE within past 2 years
Interested in becoming a CDCES?
Learn more about the CDCES eligibility requirements.
Download the CDCES informational brochure.
The Diabetes Link
CBDCE is a proud sponsor and collaborator with The Diabetes Link NextGen Leadership Program and the Resource Hub.
NextGen Fellows: The NextGen Fellowship Program is a highly-exclusive opportunity for young adults looking to jumpstart their careers in the diabetes sector, offering two tracks; Cohort A: Diabetes Research and Technology and Cohort B: Clinical Care, Education, and Patient Advocacy. Meet the current NextGen Fellows.
Learn more about the fellowship program.
NextGen Mentors: If you are passionate about helping the next generation of leaders in the diabetes community, consider becoming a mentor for the NextGen fellows. The Diabetes Link seeks various experiences, expertise, and positions in the diabetes sector from professors, researchers, software/biomedical engineers, nonprofit professionals and industry advocates. Learn more.
The Resource Hub: A comprehensive collection of resources designed to provide valuable information, tools, and support to navigate the unique challenges young adults face with diabetes. The resources are packaged in a way for those with diabetes, as well as their caregivers and healthcare professional team, to access and use quickly and easily. Visit the Resource Hub.
The CBDCE Mentorship Program was created to promote careers that will lead to a CDCES designation and improve access to much-needed diabetes care and education (DCE).
This optional mentorship program partners experienced CDCESs with health professionals who are interested in gaining experience in providing diabetes care and education. The program helps them accrue experience in order to meet the practice requirement to sit for the CDCES exam.
CBDCE has established a scholarship program to support the journey of health professionals in the specialty and to encourage diversity in the pool of health professionals holding the Certified Diabetes Care and Education Specialist (CDCES) credential. The scholarship program recipients can take the practice exam and apply for the Certification Examination for Diabetes Care and Education Specialists at no cost (valued at $405).
Recent media have highlighted treating autism with Leucovorin (Folinic Acid)
What is Leucovorin?
Leucovorin is a medication used in the treatment of methotrexate toxicity and chemotherapy regimens.1 It is a folate analog.1 Leucovorin is a 5-formyl derivative of folic acid.
Traditional use of Leucovorin1
- Decrease the toxic effects of methotrexate
- Occasionally used in the treatment of megaloblastic anemia
- May be used in palliative treatment of colon cancer in combination with 5-fluorouracil
Off-label uses include1
- Neoadjuvant treatment of bladder cancer
- Cofactor in methanol toxicity
- Prevention of hematological toxicity of pyrimethamine in patients with AIDs
- Ectopic pregnancy treatment + methotrexate
- Treatment of advanced
- Esophageal cancer
- Gastric cancer
- Pancreatic cancer
How is Cerebral Folate Deficiency (CFD) related to Autism?
According to Stefanyshyn and colleagues, autism spectrum disorders may be associated with cerebral folate deficiency. Folate receptor alpha autoantibodies (FRAA) and variants of the SLC19A1 gene are discussed as possible contributing factors. The authors aimed to investigate a specific gene variant (rs1051266 variant of the SLC19A1 gene) in patients with ASD and CFD and determine the relationship. The study included 227 children with ASD. Of these 227 children, 156 had ASD.
The authors found significant correlations between homocysteine levels and vitamins B9, B12, and B6 and between verbal impairments and vitamin B12. In ASD and CFD patients, vitamin B12 levels were elevated. In the ASD group, correlations were found between homocysteine levels and demyelination.
The findings of the above study highlight that there are many different and highly variable differences in patients who have ASD and CFD. The variant of the gene and then the specific folate abnormality are important to consider when developing a personalized plan.
Testing for CFD
Systemic deficiencies of CFD are not diagnostic because a person with CFD may have normal folate levels. CFD refers to cerebral folate deficiency, not systemic folate deficiency. The correct test would involve measuring 5-methyltetrahydrofolate in the cerebrospinal fluid obtained via a lumbar puncture.
Since this test is invasive (lumbar puncture), it is best ordered and interpreted by specialists (neurologist and geneticist).
APANP recommendations
If caregivers request leucovorin
Consider referring the child to a metabolic geneticist for genotyping and evaluation, and a neurologist for further evaluation.
Consider advising the family that there is not a single cause of autism, over 100 genes have been implicated3 as causes for autism, and there are different timelines for pathology (prenatally and postnatally).4 Therefore, it is unlikely that leucovorin is a cure-all for autism. Leucovorin has possible side effects, including seizures, syncope, hives, nausea and vomiting, abdominal toxicity, and anaphylaxis. Therefore, after appropriate genotyping, evaluation by specialists, Leucovorin may be considered an option by the specialists; however, the medication is not without risk.
Prescribing Leucovorin to all patients with ASD without first evaluating for an accurate diagnosis of cerebral folate deficiency is not appropriate. This diagnosis requires a lumbar puncture. The procedure has risks and is painful and invasive, and is best ordered by a neurologist or geneticist after careful weighing of risks and benefits.
Respectfully,
APANP
References:
- Hegde VS, Nagalli S. Leucovorin. In: StatPearls Treasure Island (FL): StatPearls Publishing; 2025 Web site. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553114/
- Stefanyshyn V, Stetsyuk R, Hrebeniuk O, et al. Analysis of the association between the SLC19A1 genetic variant (rs1051266) and autism spectrum disorders, cerebral folate deficiency, and clinical and laboratory parameters. J Mol Neurosci. 2025 Mar 29;75(2):42. doi: 10.1007/s12031-025-02338-3.
- Forrest MP, Penzes P. Autism genetics: over 100 risk genes and counting. Pediatr Neurol Briefs. 2020 Dec 4;34:13. doi: 10.15844/pedneurbriefs-34-13.
- Litman A, Sauerwald N, Green Snyder L, et al. Decomposition of phenotypic heterogeneity in autism reveals underlying genetic programs. Nat Genet. 2025, 57(7):1611-1619. doi: 10.1038/s41588-025-02224-z.