If all else fails, though, go to one of the crown jewel university hospitals in the US
they are in another dimension when it comes to the most complicated cases (that said I was surprised when I saw how relatively weak their treatment of the more standard stuff was)
that’s malpractice
FM/IM/Pediatrics should be the ones spotting it first in the vast majority of cases
Diabetic screening
Hell I used to do fundoscopic exams but never caught diabetes from that since eye problems develop relatively later.