Type 2 diabetes — newly diagnosed counselling

PLAB 2 & PRES 3 · endocrine · medium · 8 minutes

Candidate brief

You are a doctor in a GP practice. Mr Daniel Murphy, 52, has returned to discuss blood tests that confirmed type 2 diabetes. His HbA1c was 59 mmol/mol on repeat testing. Explain the diagnosis, explore his concerns and discuss an appropriate initial management plan. No physical examination is required.

What examiners look for

Explain type 2 diabetes without blame. It is a manageable long-term condition, and early treatment reduces the risk of cardiovascular, kidney, eye, nerve and foot complications. Management should combine personalised lifestyle support, structured diabetes education, appropriate medication, complication screening and planned follow-up. For UK practice, NICE NG28 was updated in February 2026. In adults without relevant comorbidity, offer modified-release metformin and an SGLT-2 inhibitor, introduced sequentially after checking suitability and tolerability. Do not impose the UK medicine pathway on an Irish PRES station. Use current Irish and local prescribing guidance. Routine home glucose testing is not required for every person with type 2 diabetes. Provide medicine-specific sick-day advice and arrange regular HbA1c, kidney, cardiovascular, foot and retinal assessment.

Guideline references

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