Syllabus · Current · V5 (2025) · Endocrine System
L2 · Endocrine Pharmacology
L2.iii · Hypoglycaemic Drugs
Understand the pharmacology of hypoglycaemic drugs.
Written examination
SAQ history
Oral Hypoglycaemics — Classification & Mechanisms
2 exam appearances
Classify the oral hypoglycaemic drugs (20% marks); include their mechanism of action (40% marks) and their most significant side effects (40% marks).
37%
Classify the oral hypoglycaemic drugs; include their mechanism of action, and their most significant side effects.
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Oral Hypoglycaemics — Selected Classes
1 exam appearance
Outline the mechanisms of action and adverse effects of the following: (a) Biguanides (35% of marks). (b) Sodium-Glucose cotransporter – 2 (SGLT-2) inhibitors (SGLT-2) (35% of marks). (c) Sulfonylureas (30% of marks).
52%
Short-acting Insulin
1 exam appearance
Oral examination
VIVA history
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2026A · VIVA 4
Relevant examiner prompt
How is insulin modified so as to alter its duration of action?
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2016B · Day 2 · VIVA 6
This viva tested knowledge of physiology around glucose utilization and the pharmacology of insulin.
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2011A · VIVA 6
This Viva will examine your knowledge of the physiology of glucose regulation and hypoglycaemic drugs as well as the physiology of the Thyroid gland Q 1. Describe the physiology of Insulin This viva began with a discussion on the physiology of insulin, physiological consequences of insulin deficiency, oral hypoglycaemic drugs and the thyroid gland. Generally candidates performed well in this viva. The role of insulin beyond metabolism of glucose, fat and protein was not well understood. The differences in the pharmacology between T4 and T3 was another area of weakness.
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2008B · VIVA 6
The initial information given to the candidates was - This viva will mostly cover pharmacology and physiology of insulin. Describe the primary function of insulin. This viva explored the candidates’ knowledge in relation to the following points Structure, mechanism of action and physiology of natural insulin Insulin preparations Pathophysiology of re-feeding syndrome Examination feedback: Candidates knowledge in relation to the physiology of insulin was good and much stronger than their knowledge in relation to the pharmacology of the different insulin preparations. It is important that candidates have a good understanding of the pharmacology of insulin preparations as well as remain up to date with changes in those preparations. Candidates also struggled with describing the basic elements, in particular the changes to electrolytes, associated with the re-feeding syndrome.
Sources: objective text from the relevant CICM syllabus; historical SAQ and VIVA wording from CICM examiner reports.