Build one useful deck, not a pile of facts

General practice covers a wide range of clinical work. A useful flashcard session starts with one task you need to perform: recognise, diagnose, assess or manage a presentation. This deck focuses on diagnosing type 2 diabetes in a non-pregnant adult and organising the first review. The diagnostic thresholds below are widely used, but testing pathways and management guidance can differ by country. Check your local clinical guidance, particularly for pregnancy, borderline results and treatment choices.

The deck is meant to be worked through, not read like a reference sheet. For each card, answer the question before looking at the answer. Then grade your recall honestly: use Again if you could not retrieve the fact, Hard if you got it with difficulty, Good if it came back correctly, and Easy if it was immediate and secure. A MySummaries flashcard session on this topic looks like this:

Cards — General Practice — Type 2 diabetes: diagnosis and first review18 due

In a non-pregnant adult, what HbA1c meets the diagnostic threshold for diabetes?

At least 48 mmol/mol (6.5%), using an appropriately standardised assay.

All 18 cards
In a non-pregnant adult, what HbA1c meets the diagnostic threshold for diabetes?At least 48 mmol/mol (6.5%), using an appropriately standardised assay.
What fasting plasma glucose meets the diagnostic threshold for diabetes?At least 7.0 mmol/L after fasting for at least 8 hours.
What 2-hour plasma glucose after a 75 g oral glucose tolerance test meets the diagnostic threshold?At least 11.1 mmol/L.
When can a random plasma glucose of at least 11.1 mmol/L diagnose diabetes?When it occurs with classic hyperglycaemic symptoms or a hyperglycaemic crisis.
What should you do if a diagnostic result is abnormal but the patient has no unequivocal hyperglycaemia?Confirm the diagnosis with a repeat abnormal test, following the local testing pathway.
When may HbA1c be unreliable for diagnosis?When red-cell turnover or haemoglobin characteristics make the result unreliable; use an appropriate plasma-glucose test instead.
Name three classic symptoms that support symptomatic hyperglycaemia.Polyuria, polydipsia and unexplained weight loss.
Which features with hyperglycaemia should prompt urgent assessment for a metabolic emergency?Acute illness with vomiting, dehydration, abdominal pain, deep or rapid breathing, drowsiness or ketones; assess urgently for diabetic ketoacidosis or another emergency.
Which kidney measures are important in the first assessment of type 2 diabetes?Check estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (ACR).
What should a basic diabetic foot assessment include?Inspect skin and footwear, assess pulses and assess protective sensation using the method recommended locally.
What eye-care step should follow a new diagnosis?Arrange or confirm retinal assessment through the local diabetic eye-screening or ophthalmology pathway.
Which cardiovascular risk factors should be reviewed at the first assessment?At least blood pressure, smoking, lipids and overall cardiovascular history or risk, with treatment guided by local recommendations.
Why review prescribed and non-prescribed medicines when assessing new hyperglycaemia?Some medicines, including glucocorticoids, can raise blood glucose and affect the clinical picture or treatment plan.
What is the general role of lifestyle support after a type 2 diabetes diagnosis?Agree practical, individualised support for eating patterns, physical activity, weight where relevant, smoking and other health priorities.
What should be checked before prescribing metformin?Assess renal function and follow local prescribing guidance for eligibility, dose and monitoring.
When should cardiorenal benefits influence glucose-lowering drug choice?When cardiovascular disease, heart failure or chronic kidney disease is present, consider therapies with relevant benefits under local guidance and eligibility criteria.
What is the principle for setting a glycaemic target?Individualise it to the person’s circumstances, treatment risks and preferences, using local guidance rather than applying one target to everyone.
What should be documented after agreeing the first management plan?The agreed goals, treatment and monitoring plan, relevant referrals or screening, and when follow-up will occur.

That is a MySummaries deck, filled with general practice material. Yours is written from your own notes. Start free

Turn recall into clinical decisions

Some cards ask for a number; others test what you do with the result. Keep those two kinds of recall connected. For example, a result at or above a threshold is not the whole consultation: you still need to decide whether symptoms make the presentation urgent, whether the result needs confirmation, and whether the test is reliable for that patient.

When a card feels too broad, split it. “Assess diabetes complications” is hard to answer and difficult to grade. Separate cards on kidney measures, foot assessment and retinal screening make the gaps visible. Conversely, avoid splitting a single threshold into several cards that test the same fact in slightly different wording. The goal is a compact deck that helps you retrieve the information in a consultation sequence.

The cards are cut from a board that keeps the thresholds beside the first-review tasks. A MySummaries board for this topic might look like this:

General Practice Type 2 diabetes: diagnosis and first reviewStudy
Assessment and managementType 2 diabetes: diagnosis and first review4 sections · 3 columns
Diagnostic thresholds
TestDiabetes threshold
HbA1c≥48 mmol/mol (6.5%)
Fasting plasma glucose≥7.0 mmol/L
2-hour 75 g OGTT≥11.1 mmol/L
Plan and follow-up

Agree individualised lifestyle and treatment goals; check local guidance for medicine choice, eligibility, monitoring and review timing.

Confirm or use another test
  • No unequivocal hyperglycaemia — confirm an abnormal result as local guidance directs
  • Potentially unreliable HbA1c — use an appropriate plasma-glucose test
First review8 due
  • Kidneys — eGFR and urine ACR
  • Complications — foot and retinal assessment
  • Risk and context — blood pressure, smoking, cardiovascular history and medicines

Keep a short core checklist

Before adding more detail, make sure you can retrieve the essentials without prompts. A checklist is not a replacement for the deck: it is a quick way to spot whether the key decisions are covered. If you miss a threshold, return to the relevant card. If you can recite the threshold but cannot say what to do next, revise the assessment and confirmation cards too.

The board’s Must not miss core for this topic is:

Must not miss coreType 2 diabetes: diagnosis and first review
Non-pregnant adult diagnostic thresholds: HbA1c ≥48 mmol/mol (6.5%); fasting plasma glucose ≥7.0 mmol/L; 2-hour 75 g OGTT ≥11.1 mmol/L.
With no unequivocal hyperglycaemia, confirm an abnormal result according to the local diagnostic pathway; do not rely on HbA1c if it may be unreliable.
At the first review, assess kidney function and albuminuria, feet, retinal screening, cardiovascular risk and medicines.
Individualise lifestyle and medication decisions; check local guidance for prescribing, eligibility, monitoring and follow-up.

Use missed marks to choose the next card

After a session, do not simply repeat every card you already know. Look at what you missed and ask why. Was it a number, a distinction between symptomatic and asymptomatic results, a limitation of HbA1c, or a practical step in the first review? Make the follow-up card test that exact gap. For example, if you remembered the HbA1c cut-off but forgot when to confirm it, practise the confirmation rule rather than rereading the entire topic.

A useful remediation prompt should be specific enough to answer in one or two sentences. A MySummaries tray card based on a repeated omission could read:

Remediation tray

You lost this mark twice: an asymptomatic adult has one HbA1c result of 50 mmol/mol. What is the next diagnostic step, and what changes if HbA1c may be unreliable?

Add cardDismiss

How MySummaries helps

Use your own notes to build a board, then turn its key points into spaced-repetition cards and review the gaps that persist. For this topic, that means keeping diagnostic thresholds, confirmation rules and first-review actions together while checking clinical decisions against the guidance used in your country. Open MySummaries.