Screening for type II diabetes
Please enter your age(18-80)

Please enter your gender 1:Male 2:Female

Please enter your Waistline(cm)

Please enter your Sagittal Abdominal Diameter(cm) (What is Sagital Abdominal Diameter?)

Do you smoke at least 100 cigarettes in life? 1:Yes 2:No

Alcohol:In any one year, have you had at least 12 drinks of any type of alcoholic beverage? By a drink, I mean a 12 oz. beer, a 5 oz. glass of wine, or a one and a half ounces of liquor. 1:Yes 2:No

Do you have Hypertension? 1:Yes 0:No

Close relative (father, mother, sister or brother) had diabetes? 1:Yes 2:No

Would you say your health in general is . . .? 1:Excellent 2:Very good 3:Good 4:Fair 5:Poor

Please enter your relative leg length(Upper leg length/height 0-1) (What is relative leg length?)

Please ener your 60 sec.pulse

Are you now controlling or losing weight? 1:Yes 2:No


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