This lesson connects the diagnostic threshold with the calendar. The diagnosis is a point. Screening is the rhythm before that point and immediately after it.
Before the diagnosis. Let us repeat the ADA 2026 framework without a new threshold: risk assessment in asymptomatic adults; testing at any age for overweight/obesity plus a risk factor (BMI ≥25, ≥23 for Asian ancestry); for everyone else, from age 35; repeat at least every 3 years, and annually in prediabetes. The tests are the same as the diagnostic ones: FPG, 2-h PG, HbA1c. In Kazakhstan, the adult screening groups for early detection of diabetes mellitus are set by a separate order (ҚР ДСМ-174/2020 is mentioned in the Standard for the Organisation of Endocrinology Care [рус.: Стандарт организации эндокринологической помощи], order of the Acting Minister of Health of the RK No. 53 of 31.03.2023). The full text of order 174/2020 was not analysed among the course's sources; a student in an RK clinic opens the current order rather than replacing it with ADA Table 2.5. Discrepancies are possible — they are named, not hidden.
At the moment T2DM is diagnosed a different calendar begins: the search for complications that may already have been developing during the years of hidden hyperglycaemia. ADA 2026 assembles it by section.
Kidney. Recommendation 11.1a: assess kidney function with a random urine albumin-to-creatinine ratio (UACR) and estimated GFR at least annually in all people with T2DM regardless of treatment; in type 1 diabetes, after ≥5 years' duration. MoH RK 2022 protocol: urine albumin-to-creatinine ratio once a year; creatinine with GFR calculation in the biochemistry panel once a year if there are no changes.
Eye. Recommendation 12.4: people with T2DM should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist at the time of diagnosis. In type 1 diabetes — 5 years after onset (12.3). If there is no retinopathy on one or more annual examinations and glycaemia is at target, every 1–2 years is acceptable (12.5). MoH RK 2022 protocol: fundus photography (fundus camera) once a year, more often if indicated; the RK endocrinology care standard separately specifies fundus photography immediately after T2DM is diagnosed.
Nerve and foot. Recommendation 12.17: assessment for diabetic peripheral neuropathy from the time of T2DM diagnosis and annually thereafter. Recommendation 12.23: a comprehensive foot evaluation at least annually. MoH RK 2022 protocol: examination of the feet and assessment of sensation at every visit; electroneurography (ENG) of the lower limbs once a year.
Heart. ADA 2026 Recommendation 10.1: blood pressure at every routine visit or at least every 6 months. MoH RK protocol: BP at every visit, ECG once a year.
The calendar does not replace clinical judgement when a symptom appears. It protects against the situation in which "there are no complications" because nobody ever looked for them.
The boundary of the module. You can say by which test and after how many confirmations the diagnosis is made, and which organs are checked on the day the diagnosis has just become legitimate. What to do next with the figure of 7.2% is a question of targets and drugs, but first — do not miss the kidney and the eye, which do not hurt.