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Evaluation

Are you evaluating a patient with diabetes mellitus?

Select the appropriate answer to indicate how satisfied you are with respect to your diabetes

The amount of time it takes to manage your diabetes?

The amount of time you spend getting checkups?

The time it takes to determine your sugar level?

Your current treatment?

The flexibility you have in your diet?

The burden your diabetes is placing on your family?

Your knowledge about your diabetes?

Your sleep?

Your social relationships and friendships?

Your sex life?

Your work, school, and household activities?

The appearance of your body?

The time you spend exercising?

Your leisure time?

Life in general?

Select the appropriate answer to indicate how often you feel the impact of your diabetes

Feel pain associated with the treatment for your diabetes?

Feel embarassed by having to deal with your diabetes in public?

Have low blood sugar?

Feel physically ill?

Find your diabetes interfering with your family life?

Have a bad night's sleep?

Find your diabetes limiting your social relationships and friendships?

Feel good about yourself?

Feel restricted by your diet?

Feel interference with your sex life?

Feel interference with your ability to drive or use a machine?

Feel interference with your exercising?

Miss work, school, or household duties?

Find yourself explaining what it means to have diabetes?

Find that your diabetes interrupts your leisure-time activites?

Tell others about your diabetes?

Experience being teased because of your diabetes?

Feel that because of your diabetes you go to the bathroom more than others?

Find that you eat something you shouldn't rather than say that you have diabetes?

Hide from others the fact that you are having an insulin reaction?

Select the appropriate answer for how often you worry

About getting married?

About having children?

About not getting the job you want?

About being denied insurance?

About being able to complete your education?

About missing work?

About being able to take a vacation or trip?

That you will pass out?

That your body looks different?

That you will get complications?

That someone will not go out with you because you have diabetes?

Results

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