When people think about type 2 diabetes, they often picture blood sugar, finger-prick tests and medicines. The quieter side of diabetes care – your feet, eyes and kidneys – can feel like a separate world of appointments, letters and unfamiliar tests.

In reality, they are all part of one story: protecting the small details that keep you independent. Being able to feel the floor under your feet, read the label on your medicine box, and have enough kidney function for everyday life makes a huge difference to your confidence.

This guide explains, in calm everyday language:

• What foot checks, eye checks and kidney tests are trying to spot early.
• Roughly how often they are usually offered in the UK.
• How they link with blood tests such as HbA1c and medicines.
• Simple ways to track what has been done each year.

It sits alongside our other diabetes pieces on blood tests, food, movement and medicines:

HbA1c & Daily Life  ·  Diabetes-Friendly Plate  ·  Movement After Meals  ·  Diabetes Medicines

Why Do Feet, Eyes and Kidneys Need Extra Attention?

Over many years, raised blood sugar can gently damage small blood vessels and nerves in different parts of the body. You cannot “see” this damage from the outside at first. That is why regular checks matter even when you feel fine.

In simple terms:

• Feet: diabetes can affect feeling (nerves) and blood flow (circulation), making it easier to miss small injuries and harder for wounds to heal.
• Eyes: tiny blood vessels at the back of the eye can become leaky or blocked over time, affecting sight if not treated early.
• Kidneys: delicate filters in the kidneys can become damaged, leading to protein leaking into urine and reduced kidney function.

The aim of regular checks is not to frighten you – it is to catch early, silent changes when they are usually easier to treat or slow down.

Foot Checks – Protecting Your Foundations

Most people with diabetes should have their feet checked at least once a year, often at the GP surgery, diabetes clinic or community podiatry service.

What usually happens at a foot check?

• Looking at the skin for dry areas, callus, cracks, colour changes or wounds.
• Checking between the toes for moisture, breaks in the skin or infection.
• Feeling pulses at the top of the foot or behind the ankle to assess circulation.
• Using a small piece of equipment (often called a monofilament) to test feeling.

At the end, you should be told whether you are currently at low, moderate or high risk of foot problems, and what that means for follow-up.

What you can do at home

• Check your feet every day if you can, or ask a family member or carer to help.
• Look for redness, swelling, breaks in the skin, blisters or colour changes.
• Keep skin moisturised (but avoid cream between the toes unless advised).
• Wear well-fitting shoes and socks; avoid walking barefoot in the house or garden.

If you notice a new wound, swelling, warmth, change in colour or pain, especially if you have reduced feeling, you should seek urgent advice. Your GP practice, podiatry service or NHS 111 can guide you on the same day pathway in your area.

Eye Checks – Seeing the Bigger Picture

In the UK, most people with diabetes are invited to a diabetic eye screening programme once a year. This is different from a normal eye test at the optician for glasses.

What happens at diabetic eye screening?

• Eye drops are usually used to widen (dilate) your pupils.
• Photos are taken of the back of your eyes (the retina) using a special camera.
• A trained grader looks for early signs of damage (retinopathy) or swelling (maculopathy).

You will receive a letter with the results. It may say:

• No diabetic eye changes seen – keep attending yearly.
• Some early changes that need closer monitoring.
• Changes that need a referral to hospital eye clinic.

It is important to keep going to appointments even if your eyesight feels “fine”. Problems can be present before you notice any blurring.

You should still see an optician regularly for glasses and general eye health – diabetic screening does not replace that.

Kidney Tests – Quiet Protectors Inside the Body

Your kidneys filter waste and extra fluid from your blood. Diabetes and high blood pressure can gently damage these filters over many years. Simple tests can spot early signs before you feel unwell.

Two main types of kidney tests

• Urine test for protein (often called ACR):
  This looks for small amounts of albumin (a type of protein) leaking into the urine. Early leakage can be a sign that the kidney filters are under strain.
• Blood test for kidney function:
  Common measures include creatinine and estimated glomerular filtration rate (eGFR). These give an idea of how well your kidneys are filtering.

These tests are usually done at least once a year for people with diabetes, often at the same time as your HbA1c and cholesterol tests.

If there are early changes, your team may:

• Review your blood pressure medicines.
• Recommend tablets that specifically protect the kidneys.
• Adjust diabetes medicines if needed.
• Ask for more frequent monitoring.

How Often Should These Checks Happen?

Everyone’s situation is different, and your team may adjust the schedule. As a rough guide for many adults with type 2 diabetes:

• Foot check: at least once a year; more often if you are at higher risk.
• Eye screening: usually once a year through the national programme.
• Kidney tests (urine and blood): at least once a year as part of your diabetes review.

If you miss an appointment or a letter does not arrive, you are allowed to ask what has happened. Sometimes invitations get lost or clinics are busy; a gentle reminder can help bring things back on track.

Linking Checks to the Bigger Picture

It can feel like your care is split into separate boxes: one clinic for blood tests, another for eye photos, another for foot care, another for medicines. Underneath, they are all connected.

Together, these checks aim to:

• Keep you walking comfortably and safely.
• Protect your eyesight so you can read, drive (if you hold a licence) and enjoy daily life.
• Look after your kidneys so they keep doing their quiet work in the background.
• Guide decisions about your food, movement and medicines.

Our article “First Year After a Type 2 Diabetes Diagnosis – What to Expect” explains how these pieces often appear during the first year and beyond:

First Year After a Type 2 Diabetes Diagnosis – What to Expect

Simple Ways to Track What Has Been Done Each Year

You do not need a complicated system to keep on top of your checks. A small notebook or a simple sheet of paper kept with your letters can be enough.

One-page annual checklist idea

Draw four columns labelled:

• Feet
• Eyes
• Kidneys (urine and blood)
• HbA1c (long-term blood sugar)

Under each heading, leave space to write:

• The date of the latest check.
• Any simple summary you were given (for example “low risk feet”, “no changes on eye screening”, “kidneys stable”).
• Any follow-up plan (for example “repeat in 6 months”, “review with kidney nurse”).

You can take this sheet to your annual diabetes review and ask your nurse or GP to help you fill in the gaps.

Questions You Can Ask About Each Check

You are allowed to understand what each test means for you. These questions are reasonable and often very helpful:

For foot checks

• “Am I currently low, moderate or high risk for foot problems?”
• “What signs in my feet should make me call same-day for advice?”
• “How often do you want to see my feet, and who should I contact if I notice a new problem?”

For eye screening

• “What did my last eye screening result show?”
• “Is there any diabetic damage at the moment, even if I can see clearly?”
• “If I miss an appointment by mistake, how do I rebook?”

For kidney tests

• “What were my latest kidney tests (urine and blood) showing?”
• “Are my kidneys stable, and is there anything more I can do to protect them?”
• “Do any of my medicines specifically protect my kidneys?”

Ten Practical Tips for Looking After the “Details”

Pick one or two that feel realistic for you this month:

1. Keep a small “diabetes folder”. Put letters from eye screening, kidney tests and foot clinics all in one place.
2. Write dates down. After each check, write the date and a simple summary in a notebook.
3. Look at your feet most days. If you cannot bend easily, use a mirror or ask for help.
4. Answer screening letters promptly. If you cannot make the appointment, call to rebook instead of ignoring it.
5. Ask for explanations in simple words. It is okay to say, “Could you explain that in everyday language?”
6. Combine appointments when possible. If you struggle with transport, ask if blood tests and reviews can be grouped.
7. Tell your team about changes. New swelling, vision changes, foot wounds or breathlessness should always be reported.
8. Link checks to habits. For example, review your “details” notebook once a month on a set day.
9. Bring someone with you. A trusted family member or friend can help remember information and ask questions.
10. Use PHAT sessions as a reminder. When you join a Zoom class, notice whether there are any checks you are due and make a note to ask your team.