Diabetes Management Survey

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Welcome to our Diabetes Management survey. You will be asked several questions about the different aspects of your experiences with diabetes. Additionally, we invite you to leave any additional comments and feedback that you believe will be helpful for us to create something that will help people manage their diabetes.

Thank you.

How old are you? *

< 18 years old

19 - 30 years old

31 - 50 years old

51+ years old

Please select the top three challenges you or someone you know have had while managing diabetes. *

Maintaining Healthy Diet/Weight

Remembering to take Medications

Testing Blood Sugar Levels

Getting Educated on Diabetes/Treatment and Management Techniques

Managing Stress/Anxiety

Cost of Diabetes Management (Medication/Office Visits/Grocery)

Required

Any other challenges that weren't listed?

I am confident in my knowledge on handling my diabetes. *

Not Confident

Completely Confident

I find it hard to eat healthily when going out with my friends/coworkers. *

Strongly Disagree

Strongly Agree

It is hard for me to establish a new routine or make changes to my existing routine. *

Strongly Disagree

Strongly Agree

I continue to regularly eat the same types of food that I grew up eating. *

Strongly Disagree

Strongly Agree

About how often do you check your blood sugar levels per week? *

0 - 3 times per week

4 - 7 times per week

8 - 12 times per week

13+ times per week

I am able to tell when I am experiencing a high or low blood sugar level. *

Strongly Disagree

Strongly Agree

Knowing the nutritional values in my food would influence my decision to consume them. *

Strongly Disagree

Strongly Agree

I feel a sense of community engaging with others in my position. *

Strongly Disagree

Strongly Agree

I spend more time managing my diabetes than I want to. *

Strongly Disagree

Strongly Agree

I have a good sense of understanding when I should not eat certain foods and what the consequences of eating them would be. *

Strongly Disagree

Strongly Agree

My friends and family are conscious of my diabetes and help support good decisions towards managing it. *

Strongly Disagree

Strongly Agree

I have been diabetic for: *

Less than one year (<1 year)

One to Three years (1-3 years)

Four to Six years (4-6 years)

More than seven years (7+ years)

Do you have any additional comments about your experience with diabetes that would be helpful?

What type of diabetes do you have? *

Type 1

Type 2

Type 1.5

I don't have diabetes (Family Member / Friend)

I don't know

Have you or someone you know personally used a continuous glucose monitor (CGM)? *

Yes, currently

Yes, but not anymore.

No, but plan to.

No, and never plan to

Please leave your email if we can follow-up with additional questions.

Thank You!

Thank you very much for your time and consideration in completing this survey. We hope that, armed with your responses and feedback, we will be able to design and create something that de-mystifies and assists people with managing their diabetes.

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