Preventing complications is not a separate chapter after "choosing the pills". It is a calendar that starts on the day of diagnosis and does not rely on the patient's memory.
A summary of the minimum, already covered organ by organ, in one place — so that it can be reproduced.
| What | When in T2DM | Source |
|---|---|---|
| HbA1c | every 3 months until the target is stable; thereafter individually, often every 3–6 months | MoH RK 2022 protocol; ADA 2026 §6, §9.14 |
| UACR + eGFR | annually, more often with progression | ADA 2026 11.1a; MoH RK protocol — annually |
| Fundus | at diagnosis, then annually (or every 1–2 years if the fundus is clear and glycaemia is at target) | ADA 2026 12.4–12.5; MoH RK protocol — fundus camera annually |
| Feet | comprehensive evaluation annually; with LOPS/ulcer — every visit | ADA 2026 12.23, 12.25; MoH RK protocol — inspection at every visit |
| Neuropathy | from diagnosis, annually | ADA 2026 12.17 |
| BP | every visit / at least every 6 months | ADA 2026 10.1; MoH RK protocol — every visit |
| Lipids | at least annually in the RK protocol (as part of the biochemistry panel) | MoH RK protocol, Table 12 |
| Education / diabetes school | everyone | MoH RK protocol; diabetes self-management education and support (DSMES), ADA 5.1 |
Self-monitoring of glucose in the MoH RK 2022 protocol depends on the regimen: on intensified insulin — at least 4 times daily; on an oral regimen and/or GLP-1 RA and/or basal insulin — at least once a day at different times plus a profile (≥4 points) once a week. ADA 2026 on technology: offer CGM to people with diabetes; for insulin therapy, CGM is recommended from onset (Section 7). This does not replace UACR and the fundus.
The non-pharmacological framework without which the calendar is empty. MoH RK protocol: diet No. 9 [рус.: диета №9], activity taking the heart into account, diabetes school, self-monitoring. DPP proved the effect of lifestyle on the prevention of diabetes in people with IGT, not on "the reversibility of glomerulosclerosis". For people who already have T2DM, ADA keeps weight management as a separate Section 8: if individual weight goals are not achieved — intensification of lifestyle, programmes, pharmacotherapy and, when indicated, metabolic surgery (9.19, level A). The MoH RK 2022 protocol recommends metabolic surgery for adults with BMI >35 kg/m² who have not achieved control after several attempts at non-surgical treatment (level 1A in the protocol's wording), by decision of a multidisciplinary team.
ADA places vaccination, dental care and smoking cessation in the comprehensive assessment (Section 4). Smoking plus LOPS or PAD — referral to a foot specialist and help with quitting (12.29). This is amputation prevention, not "general healthy living".
What the calendar does not promise. It does not promise zero myocardial infarctions. It promises that retinopathy will be found while laser and anti-VEGF can still help, that A3 will not live for three years under the name of "slightly raised protein", and that LOPS will not surface for the first time as a purulent ulcer.