Diabetes and cholesterol review (Diabetes and lipid (cholesterol) assessment and review)

What is a diabetes and cholesterol review?

A diabetes and cholesterol review is a private GP appointment that uses blood tests to check your blood sugar control and your cholesterol, and to plan how to keep both in a healthy range. It is used both to look for problems in people without a diagnosis, and to monitor people who already have diabetes or raised cholesterol.

Blood sugar is usually checked with an HbA1c test, which reflects your average blood sugar over the past two to three months. Cholesterol is checked with a lipid blood test. The results are read alongside your blood pressure, weight, smoking and family history to understand your overall risk of heart attack, stroke and diabetes complications.

The review can spot diabetes, prediabetes (blood sugar higher than normal but not yet in the diabetes range), and raised cholesterol, and can track how well existing conditions are controlled. It guides decisions about lifestyle, monitoring and, where the benefit outweighs the downsides, medicine.

These tests describe your blood at one point in time. They cannot, on their own, prove you will or will not develop complications, and a single result is not always enough — a diagnosis of diabetes usually needs confirming on a second test unless you have clear symptoms.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Prediabetes vs diabetes (HbA1c)

These thresholds are widely used in the UK but are interpreted alongside your symptoms and circumstances. Your clinician should explain what your number means rather than just labelling it.

Preparing for your test

• Check whether you need to fast; an HbA1c does not need fasting, but a fasting glucose or some lipid tests may.
• Bring a list of your medicines, including any for diabetes, blood pressure or cholesterol.
• If you already have diabetes, bring any home blood sugar or glucose-sensor readings.
• Know your family history, especially diabetes, early heart disease or very high cholesterol.
• Be ready for honest questions about diet, alcohol, activity, smoking and weight.
• Mention pregnancy, recent illness, or conditions affecting red blood cells, as these can make HbA1c less reliable.
• Think about what you want from the review and any symptoms such as thirst, tiredness or passing more urine.

What happens

A GP or nurse asks about your symptoms, family history and lifestyle, and usually checks your weight, blood pressure and sometimes your waist. A blood test checks your HbA1c (blood sugar) and a lipid profile (cholesterol), and may include kidney function.

For people who already have diabetes, an annual review adds foot checks (for circulation and sensation), and you should be referred for diabetic eye screening and have your kidneys checked. The clinician explains what the numbers mean, how they fit with your other risk factors, and the options for keeping them healthy.

If the results suggest diabetes for the first time, this is usually confirmed on a second test unless you have clear symptoms. You should leave with a clear understanding of your results, a plan, and an agreement to share results with your own GP.

Is this test right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The main pitfalls are over-reading a single result. HbA1c and cholesterol describe your blood at one point in time and can be affected by illness, recent food, pregnancy or certain conditions. A diagnosis of diabetes is usually confirmed on a second test. Ask what your numbers mean for you, whether they need repeating, and what each result would actually change before agreeing to start medicine.

Published figures to discuss

HbA1c and cholesterol results are snapshots that can be affected by illness, recent food, pregnancy and certain conditions, so a single value is not always definitive. A diabetes diagnosis is usually confirmed on a second test unless symptoms are clear. The numbers describe risk for groups of similar people rather than predicting any individual's future complications. The main harms of the review are false reassurance, anxiety from a label, and being started on treatment without a clearly confirmed need. Meaningful false-positive or false-negative rates for the review as a whole are not well defined, so no fixed figures are given here.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery. 'Afterwards' means getting your blood results, understanding what your blood sugar and cholesterol mean, and agreeing a plan — which for a new diabetes diagnosis usually includes a confirming test.

• Feeling well, as the tests themselves cause no symptoms
• A small bruise where blood was taken
• Some uncertainty or worry while you take in the results
• Being asked to repeat a test, monitor at home, or come back to review progress

Aftercare

• Make sure you understand your HbA1c and cholesterol numbers and what they mean for you.
• Agree a clear, written plan, with realistic lifestyle goals for diet, activity, weight, alcohol and smoking.
• If you have diabetes, make sure your feet, eyes and kidneys are checked and any results are followed up.
• If medicine such as a statin or a diabetes medicine is recommended, ask about the expected benefit, side effects and monitoring.
• Attend any repeat or confirming blood tests, and bring home readings if you monitor.
• Share your results and plan with your own GP so your care stays joined up.
• Seek prompt advice for symptoms such as excessive thirst, passing lots of urine, blurred vision or unexplained weight loss.
• If you take diabetes medicine and feel shaky, sweaty or confused (signs of low blood sugar), treat it and seek advice.

• List of current medicines
• Any home blood sugar or sensor readings
• Family history of diabetes or early heart disease
• Recent cholesterol or HbA1c results, if known
• Notes on diet, activity, weight, alcohol and smoking
• Questions about what your numbers mean and the options
• Your GP's details so results can be shared

⚠ Get urgent help if…

• Feeling very unwell with high blood sugar, drowsiness, deep or rapid breathing, vomiting or fruity-smelling breath — seek urgent help, as this can be a diabetic emergency
• Symptoms of very low blood sugar (shaking, sweating, confusion, drowsiness) that do not improve after treating it — seek urgent help, call 999 if someone becomes unconscious
• Excessive thirst, passing a lot of urine, blurred vision or rapid unexplained weight loss — see a doctor promptly
• A foot wound, ulcer, sudden colour change, severe pain or spreading redness if you have diabetes — seek urgent advice, as foot problems can worsen quickly
• Sudden change in vision — seek urgent eye assessment
• Chest pain, breathlessness or stroke symptoms — call 999
• Any new symptom that worries you — a normal blood test does not rule everything out

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your GP gives you.

Results & realistic expectations

A 'good' result is an accurate picture of your blood sugar and cholesterol and a clear plan, not simply a single number. In the UK, an HbA1c of 48 mmol/mol or above suggests diabetes (usually confirmed on a second test), and 42–47 mmol/mol suggests prediabetes — a warning sign that can often be improved. Cholesterol results are read alongside your overall heart and stroke risk rather than as a single 'pass' or 'fail'.

These tests cannot prove you will avoid complications or guarantee your heart is healthy. They describe your blood at one point in time and can be affected by illness, food or other conditions. The value lies in using the numbers, over time, to make sensible decisions about lifestyle, monitoring and treatment.

Blood sugar and cholesterol change over time, so results are rechecked regularly — at least yearly for diabetes, and sooner if results are high or treatment has changed. Prediabetes can move toward normal or toward diabetes depending on lifestyle and other factors, so repeat testing matters. Any plan should be reviewed as your results and circumstances change.

Related tests, treatments or support

This review is often combined with blood pressure measurement and a cardiovascular risk score, since diabetes, cholesterol and blood pressure all affect heart and stroke risk together. For people with diabetes, it sits alongside foot checks, eye screening and kidney monitoring. Where results are very abnormal, it may lead to specialist referral, for example to endocrinology or a lipid clinic.

Follow-up & long-term care

Follow-up depends on the results. A new diabetes diagnosis is confirmed and then managed with regular reviews. People with diabetes need at least an annual structured review. Anyone started on medicine needs monitoring blood tests. Borderline or prediabetes results are usually rechecked after a period of lifestyle change. Results should be shared with your GP so care is joined up.

• Recheck HbA1c and cholesterol at the intervals advised (at least yearly for diabetes)
• Keep blood pressure and weight under review alongside blood sugar and cholesterol
• If you have diabetes, attend foot checks, eye screening and kidney monitoring
• Maintain lifestyle changes — diet, activity, weight, less alcohol, no smoking
• If on medicine, attend monitoring blood tests and review side effects
• Update the review if you develop new conditions, become pregnant, or start new medicines

Repeat, follow-on and what comes next

• A first abnormal blood sugar usually needs a confirming test before diabetes is diagnosed.
• Borderline or prediabetes results are typically rechecked after a period of lifestyle change.
• Targets and treatment are adjusted over time as results, side effects and circumstances change.
• HbA1c may need replacing with a glucose-based test where it is known to be unreliable.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A clear explanation of your numbers and a written, realistic plan for lifestyle and any treatment.
• Confirmation of a new diabetes diagnosis on a second test where symptoms are not clear.
• For people with diabetes, organised foot, eye and kidney checks with named follow-up.
• Monitoring blood tests arranged if medicine is started, with side effects reviewed.
• Results shared with your GP so care is joined up, and a sensible recheck interval agreed.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The length of the appointment and whether a GP or nurse carries it out
• Which blood tests are included, such as HbA1c, a full lipid profile and kidney function
• Whether extra checks are added, such as foot examination or arranging eye screening
• Any follow-up appointment to discuss results, confirm a diagnosis or start treatment
• Whether monitoring blood tests are included if medicine is started
• Whether specialist referral, for example to a lipid or diabetes clinic, is needed afterwards

• Exactly which blood tests and checks are included
• The consultation fee and who interprets the results
• The cost of any repeat or confirming tests
• Whether a follow-up appointment to discuss results is included
• What happens, and what it costs, if treatment or further tests are recommended
• How and when you receive your results
• Whether results are shared with your GP for continuity of care

On the NHS? Blood sugar and cholesterol tests, and structured diabetes annual reviews, are widely available on the NHS when clinically indicated; private review is used for speed, choice or convenience and should be shared with your GP.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the GP is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the GP who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good GP will welcome every one of these.

• What do my HbA1c and cholesterol numbers mean for me, and do they need repeating?
• If results suggest diabetes, how will it be confirmed?
• What can I change myself before considering medicine?
• If you recommend a statin or diabetes medicine, what is the expected benefit, the side effects, and the monitoring?
• If I have diabetes, which checks (feet, eyes, kidneys) am I due, and when?
• Could my high cholesterol be inherited, and should my relatives be tested?
• How often should this be rechecked, and will you share the results with my GP?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the GP who carries out my test, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this test not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified GP for diabetes and cholesterol review

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Type 2 diabetes Diabetes UK — What is HbA1c? Diabetes UK — 15 healthcare essentials (annual review) Diabetes UK — Prediabetes NICE NG238 — CVD risk assessment and lipid modification NHS — High cholesterol NHS — NHS Health Check (eligibility)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.