Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the target HbA1c level when initiating treatment for diabetes?

1. 42 (6.0%)

2. 48 (6.5%) and 58 (7.5%) for second drug

3. 60 (7.8%)

4. 55 (7.0%)

The correct answer is: 48 (6.5%) and 58 (7.5%) for second drug

The target HbA1c level when initiating treatment for diabetes is generally set at 48 mmol/mol (6.5%). This is the threshold recommended for starting pharmacological interventions in patients diagnosed with type 2 diabetes. The rationale behind this target is that maintaining an HbA1c below this level significantly reduces the risk of diabetes-related complications such as cardiovascular disease, nephropathy, and neuropathy. Once treatment is initiated, there might be a consideration for a target HbA1c of 58 mmol/mol (7.5%) when introducing a second medication, as individualized treatment goals may be based on various factors including patient age, comorbidities, and preferences. Therefore, the option indicating 48 (6.5%) to initiate treatment and 58 (7.5%) for a subsequent drug aligns with current clinical guidelines and reflects the stepwise approach to managing diabetes effectively. In contrast, the other options either set the target level too low or too high for the initiation of treatment, which may not adequately address the risk of complications associated with higher HbA1c levels in diabetes management.