Type 2 diabetes medicines
Revise metformin, SGLT2 inhibitors, GLP-1 receptor agonists, insulin escalation, cardiovascular or renal indications, contraindications and when HbA1c targets change.
MRCGP AKT diabetes and endocrinology revision
Diabetes and endocrine questions usually test safe GP thresholds: how to interpret HbA1c or thyroid function, when a medicine is unsafe during illness, which complication must be screened, and when a vague presentation is actually an endocrine emergency.
Quick answer
For AKT diabetes and endocrinology revision, prioritise type 2 diabetes medicines, HbA1c targets, SGLT2 inhibitor safety, urine ACR and eGFR, diabetic emergencies, thyroid function tests, sick-day rules, obesity and metabolic risk, adrenal insufficiency and calcium disorders.
What to revise first
Diabetes monitoring and complications
Know HbA1c, blood pressure, lipids, urine ACR, eGFR, foot checks, retinal screening, hypoglycaemia, DKA and hyperosmolar hyperglycaemic state.
Sick-day rules
Understand medication pauses during acute illness, dehydration risk, ketone testing, insulin safety and steroid sick-day rules in adrenal insufficiency.
Thyroid disease
Focus on TSH and free T4 interpretation, subclinical disease, levothyroxine monitoring, Graves' disease, carbimazole risks and thyroid red flags.
Obesity and metabolic risk
Revise BMI and waist-to-height assessment, ethnicity and risk, hypertension, lipids, NAFLD, sleep apnoea, weight-management medicines and bariatric referral principles.
Adrenal and calcium disorders
Recognise Addison's disease, steroid emergency rules, hypercalcaemia, primary hyperparathyroidism, malignancy patterns, osteoporosis and vitamin D deficiency.
Red flags to recognise quickly
- Suspected diabetic ketoacidosis, hyperosmolar hyperglycaemic state or severe hypoglycaemia
- Vomiting, dehydration or acute illness in someone taking insulin or SGLT2 inhibitors
- Possible adrenal crisis: collapse, hypotension, vomiting, sepsis or missed steroids
- Thyroid storm, severe thyrotoxicosis, new atrial fibrillation or eye emergency
- Hypercalcaemia with confusion, dehydration, renal impairment or suspected malignancy
- Rapid unexplained weight loss, pancreatic symptoms or atypical diabetes presentation
Why endocrine questions catch candidates out
The AKT rarely asks for diabetes or thyroid facts in isolation. It usually asks what the result means for this patient: which medicine is unsafe, which complication changes the target, which symptom needs urgent action, or which monitoring step has been missed.
AKT diabetes and endocrinology FAQ
Is diabetes and endocrinology high yield for the MRCGP AKT?
Yes. The RCGP metabolic and endocrinology topic includes diabetes, thyroid disease, obesity, adrenal disease, calcium disorders, biochemical test interpretation, chronic disease monitoring and endocrine emergencies.
What diabetes topics should I revise for the AKT?
Prioritise type 2 diabetes medicines, HbA1c targets, SGLT2 inhibitor cautions, GLP-1 receptor agonists, insulin safety, hypoglycaemia, DKA, HHS, urine ACR, eGFR, foot checks and retinal screening.
How does thyroid disease come up in AKT questions?
Thyroid questions often test TSH and free T4 interpretation, subclinical hypothyroidism, levothyroxine monitoring, Graves' disease, carbimazole adverse effects, pregnancy considerations and urgent thyrotoxicosis red flags.
What sick-day rules are high yield for AKT endocrinology?
Know when acute illness changes diabetes treatment, when to pause dehydration-risk medicines, when to check ketones, why insulin should not be stopped casually, and why adrenal insufficiency needs steroid sick-day escalation.
Official sources
This is revision guidance, not official RCGP advice. Check current RCGP, NICE CKS and BNF guidance for clinical decisions. Last reviewed June 2026.
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