Read the current Defeat Diabetes® E-Lerts™ Newsletter

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Rewarding for
you and us
Defeat Diabetes Foundation
    
      
       
Defeat Diabetes
Foundation
150 153rd Ave,
Suite 300
Madeira Beach, FL 33708  

Special Offer for Elementary and Middle Schools, Scouting Organizations, Boy's and Girl's Clubs, and Civic, Religious or Fraternal Organizations

 

If you would like to distribute the printed version of the Defeat Diabetes® Screening Test to your students or membership, we will provide them free of charge. You may mail, fax or email your request. Please include the following information:

Name and Address of Organization, Quantity Requested in English, Requested Date of Delivery (at least 2 weeks please), Name and Telephone Number of Contact Person.

Address:
Defeat Diabetes Foundation
150 153rd Avenue, Suite 300
Madeira Beach, FL 33708 		Fax: 727.398.2144
Email: ScreeningTest@DefeatDiabetes.org

 

Take the Test

Diabetes can be life threatening! But with early detection it is manageable. This test is designed to allow you to answer questions that may indicate that a diabetic condition exists. It is not intended to replace or be a substitute for a clinical exam, which should be completed in an appropriate setting, such as your doctor's office. It is now estimated that over 24 million Americans (285 million people worldwide) have diabetes and at least one third don't know it! Please take a moment to answer the test questions.

Instructions:

(1.)

Complete each question by indicating the degree of incidence.
(2.)

Your "Total Number of Points" is automatically calculated as you answer the questions and is displayed in the box below the test. "Points" are scored this way:
High incidence=10 points / Medium incidence=5 points / Low incidence=0 points


The Screening Test

1. I go to the bathroom (urinate) often (every 2 to 3 hours):
High Medium Low
2. I am always thirsty and/or hungry:
High Medium Low
3. I am suddenly losing a lot of weight:
High Medium Low
4. I am always fatigued (weak, tired) and/or drowsy:
High Medium Low
5. I am irritable and have mood changes:
High Medium Low
6. I am nauseous and/or vomit often:
High Medium Low
7. I have blurred vision:
High Medium Low
8. I have a tingling or numbness in my legs, feet or fingers:
High Medium Low
9. I have frequent or recurring skin, gum and/or urinary tract infections:
High Medium Low
10. I have frequent itching of my skin and/or genitals:
High Medium Low
11. I have slow healing of cuts and bruises:
High Medium Low
12. My family history shows diabetes:
Don't Know Yes No
13. My Age is:
Over 65 45 to 65 Under 45
14. I am:
Obese
   (over 20% overweight)		 Overweight Not Overweight
15. For women, if you have a history of gestational diabetes (the type that occurs during pregnancy) or have delivered a baby over 9 pounds.
Yes No
16. If you are Asian, Black, Hispanic/Latino, Pacific Islander or Native American, medical data shows that within these ethnic groups there are extremely high diabetic populations.
I am Asian, Black, Hispanic/Latino, Pacific Islander or Native  American. I am Caucasian
17. Indications of Acanthosis Nigricans (AN), a skin condition characterized by darkened, velvety and/or thickened skin patches.
Yes No
18. Necrobiosis Lipoidica Diabeticorum (NLD), slightly raised shiny red-brown patches on my lower legs, mostly in women.
Yes No


Scoring Your DEFEAT DIABETES® SCREENING TEST

0 to 15 Points : You are at low risk for having diabetes.

20 to 30 Points : You probably have pre-diabetes and should get tested.

35 or More Points : You have scored very high and should seek medical evaluation!

 
 
 
 
 
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Help us study how diabetes management influences the quality of lives of people with Type 2 Diabetes.
 
You will receive a $15 gift card upon completion.
For more information click Take the survey here.
This study is fully supported by Defeat Diabetes Foundation. 
 
 

Send your unopened, unexpired test strips to:


Defeat Diabetes Foundation
150 153rd Ave, Suite 300
Madeira Beach, FL 33708

 

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