Diabetes Consultation

Step 2: Medical Info

Height (cm) Weight (kg) Consultation For Select Diabetes / Sugar Heart Problems / Cholesterol Joint Pain / Back Pain Digestion / Gut Health HbA1c Level Select Below 5.6 6–7 7–8 Above 8 Urination per Day Wake at Night to Urinate? Select Never Sometimes Once or twice daily More than twice daily Joint Pain Location Select Knee joint Back Small finger joints Multiple joints Neck Pain Duration Pain increases with activity? Select Yes No Swelling in Joint? Select Present Absent History of Injury / Trauma? Select Yes No Morning Stiffness Present? Select Yes No If Yes, Stiffness Duration Select Less than 1 hour More than 1 hour Additional Comments