Type 2 diabetes

Endocrinology and metabolism · Known disease · updated 2026-10-30

BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.

Frequency: more than 4.2 million patients in 2023, i.e. 93% of people with diabetes ^[1]

Quarterly (or twice-yearly) tests

Glycated haemoglobin (HbA1c)
Fructosamine, in place of HbA1c if it is unreliable (haemoglobinopathy, haemolysis)if needednon-French guidelineIn the United Kingdom, NICE proposes monitoring glycaemic control with fructosamine, or with plasma glucose profiles, when HbA1c is unreliable because of disturbed red cell turnover or abnormal haemoglobin ^[2]. The 2025 HAS guide does not mention fructosamine ^[1].

Detailed explanation and international comparison (in French): read it in English (machine translation)

Fasting sample.

HbA1c
Serum creatinine with eGFR
Lipid profile
FBC (platelets, for the FIB-4 score)
AST
ALT
GGT
Alkaline phosphatase
PT
Vitamin B12 (on metformin, if anaemia, neuropathy or risk factor for deficiency)if neededPatient on metformin with anaemia, neuropathy or a risk factor for vitamin B12 deficiency: the SmPC (RCP) then asks for the measurement, and regular monitoring in at-risk patients ^[6]; HAS asks for particular attention to B12 deficiency on metformin ^[3].

Urine albumin:creatinine ratio (ACR) on a spot urine sample, preferably in the morning

Detailed explanation and international comparison (in French): read it in English (machine translation)

On an ACE inhibitor or ARB? If an ACE inhibitor or ARB is prescribed or changed, check serum potassium and creatinine: see the page "Starting or changing the dose of an ACE inhibitor/ARB".
Low GFR or abnormal albuminuria? If GFR is low or albuminuria persistently abnormal, follow the page "Kidney failure".

HbA1c to screen for or diagnose diabetes: the NABM reserves it for monitoring of glycaemic control ^[15] (see the page “Diabetes: discovery of hyperglycaemia”).

Sources (15)