Question 1/10

Have you been diagnosed with diabetes or prediabetes?

Yes
No
Unsure

Question 2/10

How often do you check your blood sugar levels?

Daily
Occasionally
Rarely
Never

Question 3/10

Are you aware of your HbA1c levels?

Yes
No

Question 4/10

Do you experience frequent thirst or urination?

Yes
No

Question 5/10

How would you describe your diet?

High in carbs
Balanced
Low-sugar
Poor

Question 6/10

How often do you consume sugary foods or beverages?

Daily
Occasionally
Rarely
Never

Question 7/10

Do you experience tingling or numbness in your hands or feet?

Yes
No

Question 8/10

How often do you engage in physical activity?

Never
1–2 times per week
3–5 times per week
Daily

Question 9/10

Have you discussed diabetes management with a healthcare provider in the last year?

Yes
No

Question 10/10

Do you currently take medication or insulin for diabetes?

Yes
No