Risk Assessment Test

  1. I weigh at least 20% more than my ideal body weight
  2. My close relative has diabetes (parents and/or siblings)
  3. I often feel thirsty
  4. I wake up to urinate two times or more every night
  5. I am tired most of the time
  6. I have unexplained weight loss
  7. I have pain, numbness or tingling in my feet
  8. I sometimes experience blurred vision
  9. I am over 40 years old
  10. I am of Native American, Hispanic, Asian, or African-American descent
  11. I have high blood pressure (over 140/90)
  12. I have elevated levels of cholesterol (over 200 mg/dl) or triglycerides (over 150 mg/dl)
  13. I am a woman who has had a history of diabetes during pregnancy, or more than one baby weighing over 9lbs. at birth

Please score one point for every YES answer.

Your Score:

A score of 3 or more indicates a recommendation for a fasting blood glucose test.
Please call the Diabetes Education Center of the Midlands at 402-399-8444 for more information.

Remember Your Normal Blood Sugars:
Fasting: 80-110 mg/dl
2 hours after eating meals: 80-120 mg/dl


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Diabetes Education Center of the Midlands
info@diabetes-education.com
2910 South 84th St.
Omaha, NE 68124
1-800-779-3374

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