Type 2 Diabetes Tests and Exams That Are Easy to Miss

A1c gets checked; the other routine type 2 diabetes checks are easier to lose. Several of them look for problems that cause no symptoms early on, and they are done in different places (the primary care office, an eye doctor, sometimes a foot specialist), so one can slip without anyone noticing. Below is each routine check in the American Diabetes Association's Standards of Care in Diabetes 2026, with the schedule the ADA states. It is a list of what to ask about, not advice about what you need.

For A1c and eGFR questions in more depth, see our page of questions to ask about A1c and eGFR.

The routine checks and what the ADA says

• A1c (or another measure of glucose). The ADA says to assess glycemic status at least two times a year, and more often, for example every 3 months, if you are not meeting your goals or your treatment recently changed.
• Kidney tests: UACR and eGFR. The ADA says to assess urine albumin (UACR) and eGFR at least annually in all people with type 2 diabetes regardless of treatment, and one to four times a year once chronic kidney disease is present. Our page on kidney tests to track with type 2 diabetes goes further.
• Dilated eye exam. The ADA says to have an initial dilated and comprehensive eye exam at the time of diagnosis. If there is no retinopathy on one or more yearly exams and glucose levels are at goal, it says every 1 to 2 years may be considered; with any retinopathy, at least once a year.
• Foot exam. The ADA says to perform a comprehensive foot evaluation at least annually, and lists yearly 10-g monofilament testing to check sensation.
• Cholesterol (lipid profile). The ADA says to obtain a lipid profile at diagnosis, at an initial medical evaluation, and annually thereafter for people not taking a statin, or more often if indicated. For people starting a statin or changing the dose, it says to check 4 to 12 weeks later and then once a year.
• Blood pressure. The ADA says blood pressure should be measured at every routine clinical visit, or at least every 6 months, and to counsel people with high blood pressure and diabetes to monitor it at home.
• Liver screening (FIB-4). The ADA says to screen adults with type 2 diabetes, particularly those with obesity or other cardiometabolic risk factors, for liver scarring using FIB-4, which is calculated from routine blood tests, even if liver enzymes are normal.
• Vitamin B12 on metformin. The ADA says to consider periodic assessment of vitamin B12 in people taking metformin long term, especially with anemia or peripheral neuropathy.
• Mood and diabetes distress. The ADA says to screen for depressive symptoms in all people with diabetes at least annually, and to screen for diabetes distress at least annually.
• Vaccines. The ADA says to provide routinely recommended vaccinations as indicated by age, and its table, taken from the CDC, includes COVID-19, hepatitis B and influenza among others.

Questions to ask your clinician

• When were my last UACR and eGFR, and is either one due?
• When was my last dilated eye exam, and who sends the result to my other doctors?
• Has a full foot exam, including the monofilament test, been done this year?
• Should my liver be screened with FIB-4 from my routine blood tests?
• I take metformin. Has my vitamin B12 been checked?
• When was my cholesterol last checked, and when is it next due?
• Can we talk about mood, stress and diabetes distress at my next visit?

A free check you can run with your AI assistant

If you use Claude or ChatGPT and have connected it to philongevity.com/mcp (the steps are on our page for AI assistants), ask it to run the Phi Longevity care-gaps check. It needs no lab values, dates, names or records: only your condition, a few types of medicine, and for each routine test whether it was done recently, overdue, never done, or you are not sure. It returns the same list as this page, in order, with the guideline behind each item, the questions to ask each clinician, and a one-page checklist to print. It is decision support for visit preparation, not a diagnosis.

What to do with the files

1. Download your lab reports from each place you have been seen (how to download lab results from MyChart).
2. Connect MyChart at participating Epic health systems, or upload the reports, in your own account at philongevity.com.
3. Phi Longevity PRISM builds a one-page Care Team Brief with each result, its date, its trend and the guideline behind each flag, and for type 2 diabetes it points out tests that look overdue. See our one-page diabetes and kidney summary and the type 2 diabetes lab guide.

Phi Longevity is not a healthcare provider or a "covered entity" under HIPAA for your personal account. We store your records in HIPAA-eligible systems under a signed business associate agreement with Google Cloud, and we protect them to that standard. You can ask us to delete your data at any time.

Your first Care Team Brief is free. Phi Longevity Complete is $19/month and keeps the brief current as new results arrive.

Start free: see which diabetes checks look overdue →

What Phi Longevity PRISM does not do

It does not diagnose, and it does not tell you which tests you need, how often, or what a result means for you. The schedules on this page are the general ones the guidelines state; your clinician may set a different one. It reads lab results today; medicines, diagnoses and allergies are not imported yet. It uses the range printed on your own lab report and never swaps in its own. Your clinician decides what you need.