Once diabetes is diagnosed, have the back of the eye checked once, then on the interval the doctor sets; check the feet once a year
Grade ABig benefitLifespanLow costLittle timeSome willpower
When diabetes has damaged the back of the eye or the feet, there is almost no feeling until vision is gone or the foot starts to break down. Caught early, it can still be treated. Have a dilated fundus exam at the diagnosis of type 2 diabetes; for type 1, start 5 years after onset. If early checks were normal and blood sugar is at target, the interval can widen to once a year or every other year. Check the feet once a year.
- Cost
- A dilated fundus exam costs from a few dozen to a few hundred CNY. A foot exam is usually included in the outpatient visit and is not charged separately. The hard part is remembering to go when the eyes and the feet feel fine.
- Benefit
- Damage from diabetes to the back of the eye is called retinopathy; damage to the foot is called diabetic foot. Both are almost without feeling before they go wrong. Caught early, they can still be treated. Once vision is gone or the foot has broken down, it is late
- Notes
- Type 2 diabetes needs the exam at diagnosis; type 1 starts 5 years after onset. The difference is that type 2 has often been quietly high for years. If early checks were normal and blood sugar is at target, the interval can widen to once every 1 to 2 years. If sensation in the feet has dulled, look at the sole yourself every day; a mirror is fine. The kidneys should also be checked every year; see item 13 (urine albumin-to-creatinine ratio).
Sources · 1
- 美国糖尿病学会 (2026). 糖尿病诊疗标准 2026·第 12 章 视网膜病变、神经病变与足部护理. Diabetes Care：「People with type 2 diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist at the time of the diabetes diagnosis.」「Adults with type 1 diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist 5 years after the onset of diabetes.」「If there is no evidence of retinopathy from one or more annual eye exams and glycemic indicators are within the goal range, then screening every 1–2 years may be considered.」「Perform a comprehensive foot evaluation at least annually to identify risk factors for ulcers and amputations.」doi.org/10.2337/dc26-S012