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I'm doing pretty well in the simulators (85+) however I fear it wouldn't be the same on the exam since there are many topics I just manage in the question but haven't mastered. How much does exam day performance differ usually from the simulators or past papers considering we compare it to a simulator of the same difficulty?
What matters is consistency. If you are regularly getting 85+ on simulators, you are doing extremely well and it is unlikely that you just got lucky with the question topics. The simulators are typically as difficult as the IMAT papers (of course, some simulators are easier than others, but this is true for the IMAT as well).
You can also do an IMAT past paper to see how your score looks there.