Getting to Know You

What’s your biggest challenge with diabetes right now? (Select all that apply)*

What’s your diabetes story? (How long have you been living with T2D and what prompted your diagnosis?)*

Characters remaining: 400

On a scale of “Constantly Frustrated” to “Totally Confident,” how would you describe your current diabetes management?

Constantly Frustrated

Managing Day-to-Day

Often Struggling

Generally Confident

Totally Confident

How motivated are you to take total control of your diabetes journey?

Very motivated - I’m ready to do whatever it takes

Moderately motivated - I want to, but have some hesitations

Somewhat motivated

Not very motivated

I am not sure

What’s your biggest challenge with diabetes right now?

Blood sugar control

Medication side effects

Weight management

Dietary restrictions

Exercise motivation

Healthcare costs

Other

How supportive is your healthcare team in helping you work toward diabetes improvement (not just management)?

They don’t seem to believe that improvement is possible

They focus only on medications

Somewhat supportive of lifestyle approaches

Very supportive and proactive

I don’t have regular healthcare for my diabetes

Which current approaches are you using to manage your diabetes?

Prescription medications

Dietary changes

Regular exercise

Supplements

Alternative therapies

Other

Where do you typically learn about diabetes research and treatment options?

Doctor or healthcare provider

Online diabetes communities

Medical websites

Social media

Books/magazines

Friends and family

Other

Do you follow any diabetes influencers or experts? If so, who are they?

Where are you located? City: State/Province: Country:

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Approximately how much would you estimate managing your diabetes costs you every year?

Less than $500

$500 - $1,000

$1,001 - $2,500

$2,501 - $5,000

$5,001 - $10,000

More than $10,000

Prefer not to say

What topics would you most like to see covered in the MrT2D newsletter? (Select your top 3)

Success stories of T2D improvement/reversal

Latest research on diabetes reversal

Exercise strategies for diabetes

Managing medications

Mental health and diabetes

Alternative/complementary approaches

Other

How did you hear about our newsletter?

Social Media

Friend/family recommendation

Healthcare provider

Online Search

Other