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Type 2 Diabetes
Risk Questionnaire
Please fill out the information below. All fields are mandatory
Step 1 of 2
Health Information
Gender
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Weight (Kg)
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Height (ft or cms)
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Age
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Waist size (inches or cm)
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Physically active for more than 30 minutes every day?
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Frequency of eating vegetables and fruits?
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Ever taken medication for high blood pressure on a regular basis?
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Ever found to have high blood glucose (e.g. in a health examination, during an illness, during pregnancy)?
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Grandparent, aunt, uncle, or first cousin diagnosed with diabetes (type 1 or type 2)?
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Parent, brother, sister, or own child been diagnosed with diabetes (type 1 or type 2)?
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Continue to Step 2
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