Diabetes · Elderly Care · NHS Care Pathways
Diabetes Annual Review: What Your Elderly Parent Should Expect and How to Prepare
Updated June 2026·8 min read
If your mum or dad has type 2 diabetes, they're entitled to a yearly check-up called a diabetes annual review — a set of tests and conversations designed to catch problems early and keep their treatment on track.
Many people who've lived with diabetes for years have only a vague idea of what's actually checked, and most adult children helping a parent manage their health have even less. This diabetes annual review checklist covers exactly what should happen, why each part matters, and how to help your parent prepare — so nothing important gets missed.
What is a diabetes annual review?
A diabetes annual review is a routine part of NHS care — not an optional extra. Everyone living with diabetes in the UK is entitled to a set of health checks at least once a year, arranged through their GP practice or diabetes clinic.
Some checks happen every time your parent sees their diabetes team — blood pressure, for instance. Others, like the foot check or eye screening, are done annually or sometimes every two years if previous results were clear. It's a planned, preventative appointment, not something to wait for until a problem shows up.
What should be checked — the full diabetes health checks list
According to Diabetes UK, these are the checks everyone with diabetes should be offered as part of their annual review:
| Check | What it's for | How often |
|---|---|---|
| HbA1c | Average blood sugar level over the past 2–3 months | Every visit / at least annually |
| Cholesterol | Fat levels in the blood — a cardiovascular risk marker | Annually |
| Kidney function | Blood and urine tests to check for early kidney damage | Annually |
| Foot check | Checks circulation and nerve sensation in the feet | Annually, or every 2 years if clear |
| Eye screening | Photographs of the retina to check for diabetic retinopathy | Annually, or every 2 years if clear (separate appointment) |
| Blood pressure | Checked as part of cardiovascular risk | Every visit |
| Weight / BMI | Tracked over time as part of overall management | Annually |
| Smoking status | Asked at every review, with support offered if needed | Every visit |
Two of these — the foot check and eye screening — are sometimes done by a different team and may not happen on the same day as the rest of the review. It's worth checking with the GP practice whether your parent's eye screening has been booked separately, since it's easy for this one to slip through unnoticed if it's not bundled with everything else.
Anyone newly diagnosed should also receive a full review of their medical history and personal circumstances, plus a referral to a diabetes education programme — worth asking about if your parent was diagnosed recently and doesn't remember being offered this.
Why HbA1c targets are different for older people
This is the part most people — including many people who've had diabetes for years — don't fully understand, and it matters a great deal for older adults specifically.
NICE guidance (NG28) sets the standard HbA1c target at 48 mmol/mol (6.5%) for people managed by lifestyle measures or a single medicine that doesn't cause low blood sugar, such as metformin. For people on medicines that carry a risk of hypoglycaemia — including insulin or sulphonylureas — the target is a little higher, at 53 mmol/mol (7.0%).
What this means in practice: if your parent's HbA1c looks higher than the “standard” 48 you might read about online, that isn't automatically a sign their diabetes is poorly controlled. It may simply reflect a target that's been deliberately relaxed for their safety. The only way to know is to ask what target has actually been set for them, and why.
A note on hypoglycaemia in older adults
Older people are more vulnerable to low blood sugar (hypoglycaemia), and it can look different in later life — sometimes showing up as confusion, drowsiness or unsteadiness rather than the classic shakiness or hunger. This matters because it can be mistaken for something else entirely, including the early signs of dementia. If your parent ever seems unusually confused, shaky or drowsy, treat it as a possible sign of low blood sugar: contact their GP or NHS 111 for guidance, or call 999 if symptoms are severe or they lose consciousness.
Questions worth asking at the appointment
A short list of direct questions can make the appointment far more useful — whether you're going along or simply helping your parent prepare beforehand.
- “What's my individual HbA1c target, and why has it been set at that level?”
- “Have all the checks on the standard annual review list been done this year — including the foot check and eye screening?”
- “Are there any early signs of complications we should be keeping an eye on?”
- “Given any other health changes this year, is the current medication still the right fit?”
- “What would unusually low blood sugar look like for my parent specifically?”
How to help your parent prepare
A little preparation goes a long way toward making sure the review actually covers everything it should.
- Note any changes from the past year. Not just “everything's been fine,” but anything specific — new symptoms, falls, changes in eyesight, wounds that healed slowly, or simply feeling different day to day.
- Bring a full list of current medication. Not only diabetes medicines — anything new prescribed for another condition can affect how diabetes medication works, and vice versa.
- Offer to go along, even briefly. If your parent finds it hard to remember or relay what's discussed, having someone else there to listen and ask questions can make a real difference to what actually gets covered.
- If they're reluctant to keep notes themselves, you can. A short list of “things to mention” prepared together beforehand is often more welcome than trying to take charge of the whole conversation.
Know how they've really been doing, not just on the day of the appointment
Hea checks in each morning with a simple, friendly question — mood, sleep, energy. Over several weeks, that builds into a picture you can bring alongside the clinical checks at your parent's next review. It can also flag when something looks off and suggest what to do next.
See how Hea worksFrequently asked questions
How often is a diabetes annual review?
At least once a year for everyone with diabetes. Some individual checks — like blood pressure — happen at every visit, while others, such as the foot check and eye screening, may move to once every two years if previous results were clear.
What happens if my parent misses their review?
There's no penalty, but it does mean a missed opportunity to catch any early changes. If a review has been missed, it's worth contacting the GP practice as soon as possible to get it rebooked, rather than waiting for the next automatic invitation.
Can I go to the appointment with my parent?
Yes — and most practices welcome this. A second person in the room can help remember what's discussed afterwards and ask questions your parent might not think to raise on their own.
Is a high HbA1c always a problem for an elderly person?
Not necessarily. Treatment targets are often deliberately relaxed for older or frail adults to reduce the risk of hypoglycaemia, so a number that looks high by general standards may still be appropriate for your specific parent. The only way to know is to ask what their individual target actually is.
Sources
- Diabetes UK, Diabetes health checks (annual review) — diabetes.org.uk/about-diabetes/looking-after-diabetes/care-to-expect
- Diabetes UK, Your annual diabetes foot check — diabetes.org.uk
- Diabetes UK, Diabetic eye screening — diabetes.org.uk/about-diabetes/looking-after-diabetes/diabetic-eye-screening
- NICE, Type 2 diabetes in adults: management (NG28) — nice.org.uk/guidance/ng28
- NHS, Diabetic eye screening — nhs.uk/tests-and-treatments/diabetic-eye-screening
- GOV.UK, Diabetic eye screening: programme overview — gov.uk/guidance/diabetic-eye-screening-programme-overview
