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The Annual Checkup Checklist for Type 2 Diabetes
Oct
The screening tests worth asking about each year, and why feeling fine is not the same as being checked.
If you have type 2 diabetes, you probably know your A1C. But your yearly checkup can include much more than a blood sugar test. Several quick, simple screenings can catch problems with your kidneys, eyes, nerves, feet, and liver long before you would notice anything yourself.
That timing matters. Many diabetes complications develop slowly and cause no symptoms in their early stages. Up to half of people with diabetic nerve damage in the feet may have no symptoms at all, according to the American Diabetes Association (ADA). Early kidney disease and early diabetic eye disease are often silent too.
The good news is that silent does not mean undetectable. Screening tests are designed to find these changes early, when treatment tends to work best. The checklist below brings the main recommendations together in one place.
Your yearly screening checklist
These are general guidelines for adults with type 2 diabetes. Your healthcare team may recommend a different schedule based on your health and past results.
| What to check | Test | How often (general guide) |
|---|---|---|
| Blood sugar | A1C blood test | Usually every 3 to 6 months |
| Blood pressure | Office reading, plus home monitoring if advised | Every visit |
| Cholesterol | Lipid panel (blood test) | Usually at least once a year |
| Kidneys | eGFR (blood test) and UACR (urine test) | At least once a year, starting at diagnosis |
| Eyes | Dilated eye exam | At diagnosis, then yearly, or every 1 to 2 years if exams are normal |
| Nerves | Monofilament test and other quick sensation checks | At diagnosis, then at least once a year |
| Feet | Comprehensive foot exam | At least once a year; more often if your risk is higher |
| Liver | FIB-4 score (calculated from routine blood work) | Periodically, based on your risk |
| Mouth | Dental exam and cleaning | As your dentist advises |
| Emotional health | Screening for diabetes distress, depression, and anxiety | At least once a year |
Tip: copy this table into your phone or a notebook. Write down the date and result of each test, and mark when the next one is due.
Four tests that are easy to miss
1. The UACR urine test (kidneys)
Most people get an eGFR result with routine bloodwork. It shows how well your kidneys filter. But early kidney damage often shows up first as a protein called albumin leaking into the urine, and only a urine test called the UACR (urine albumin-to-creatinine ratio) detects that.
The ADA recommends both tests for everyone with type 2 diabetes, starting at diagnosis. Diabetes is the leading cause of chronic kidney disease, and about one in three adults with diabetes has it. If you are not sure you had a UACR test this year, ask.
2. The dilated eye exam (eyes)
Seeing clearly does not mean your eyes are healthy. Diabetic retinopathy, damage to the back of the eye, can reach a sight-threatening stage without any change in your vision. The ADA recommends a dilated eye exam at diagnosis because many people have had high blood sugar for years before they are diagnosed.
After that, exams are generally yearly. If one or more exams show no retinopathy and your glucose is in your goal range, your eye care professional may suggest every one to two years instead.
3. The foot exam (nerves and circulation)
Nerve damage can stop you from feeling a blister, cut, or pebble in your shoe. The monofilament test, where a thin nylon strand is pressed gently against the sole of your foot, checks for that loss of feeling. The ADA recommends it at least once a year, along with a full foot exam that checks your skin, foot shape, and pulses.
It only takes a minute, but busy appointments sometimes skip it. Taking off your shoes and socks at the start of the visit is a simple reminder.
4. The FIB-4 score (liver)
Fatty liver disease, now called MASLD, affects most people with type 2 diabetes, and it is usually silent. Standard liver enzyme tests often look normal even when there is significant scarring.
The FIB-4 score helps fill that gap. It is calculated from your age, two liver enzymes, and your platelet count, which are often already in your bloodwork. A 2025 ADA consensus report recommends it for people with type 2 diabetes or prediabetes, especially those with obesity. If your score is in the intermediate range, a quick, painless liver stiffness scan is usually the next step.
How to prepare for your checkup
A few minutes of preparation can make a short appointment much more useful.
Before the visit
- Check the table above and note which tests are due.
- Update your list of medications, including over-the-counter medicines and supplements.
- Bring your glucose readings or CGM report, plus your home blood pressure log if you keep one.
- Write down any new symptoms, even ones that seem minor, such as leg pain when walking or bleeding gums.
Questions to ask
- Which screening tests are due for me this year?
- Was a UACR urine test included in my lab work?
- What are my actual numbers, and what are my goals for each?
- Has my FIB-4 score been calculated?
- When is my next dilated eye exam due?
- Do any of my results mean I should see a specialist?
Ask for your actual numbers rather than just “normal” or “a little high.” Knowing your numbers makes it easier to spot trends and to ask better questions next time.
The bottom line
Feeling well is good news, but it is not the same as being checked. Most diabetes complications develop gradually, and regular screening is the most reliable way to catch them early. Many can be slowed or managed when they are found in time.
You do not have to remember everything at once. Start by checking which tests on this list are overdue, then schedule them.
Want the full picture? Our ebook Beyond Blood Sugar: Understanding and Reducing Your Risk of Type 2 Diabetes Complications explains each of these tests in plain language. It covers what the results mean, which warning signs need prompt care, and the steps that can help lower your risk.
This article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional about your own health and screening schedule. Information reviewed October 2026.
