Eyes, Kidneys, Nerves and Feet
Reviewed by CDE Mehandi Sharma · Updated
If you have a progressive subtype — HNF1A, HNF4A or another with declining beta-cell function — microvascular screening applies to you as it would in any diabetes, and each check has a specific job.
Eyes. A dilated eye examination at least once a year. Dilated is the important word: drops widen the pupil so the whole retina can be examined, and a routine spectacle test will not detect early damage. Early retinopathy causes no symptoms, which is the entire reason for screening.
Kidneys. A urine test for small amounts of albumin, plus a blood test estimating filtration rate, at least yearly. Small amounts of protein in the urine are the earliest detectable sign, and that is the stage where a great deal can be done. Blood pressure control matters here as much as glucose.
Nerves and feet. A foot examination at each review, plus a daily look yourself — tops, soles, between the toes, heels. Reduced sensation means injuries stop hurting, and an unnoticed wound is the real danger.
Barefoot walking indoors and at temples is a specific Indian risk worth naming, as is checking inside footwear before putting it on.
If you have GCK-MODY, the calculus is different — complications are uncommon and your doctor may recommend a lighter schedule. Do not assume, though; ask.