Twin City Hospital
819 N. First Street
Dennison, OH 44621
(740) 922-2800
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      September 5, 2010
 


Take this test to see if you are at risk for having diabetes. Diabetes is more common in African Americans, Latinos, Native Americans, Asian Americans, and Pacific Islanders. If you are a member of one of these ethnic groups, you need to pay special attention to this test.
  1. I am a woman who has had a baby weighing more than nine pounds at birth.
    Yes No

  2. I have a sister or brother with diabetes.
    Yes No

  3. I have a parent with diabetes.
    Yes No

  4. My weight is equal to or above that listed in the following chart.
    Yes No


  5. I am under 65 years of age and I get little or no exercise.
    Yes No

  6. I am between 45 and 64 years of age.
    Yes No

  7. I am 65 years old or older.
    Yes No

  8. Please enter your zip code (optional):

Diabetes Facts You Should Know
Diabetes is a serious disease that can lead to blindness, heart disease, strokes, kidney failure, and loss of a limb.

You are at greater risk for diabetes if:
You are age 45 and older • You are overweight
You have high blood pressure • You have a family history of diabetes





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