Type 2 Diabetes Risk Assessment Form

Complete the assessment to receive your type 2 diabetes risk evaluation.

These questionnaires are designed to assess your 10-year risk of developing type 2 diabetes. They are based on the Diabetes Risk Score (DRS)* from the 4th Thai Health Survey conducted in 2009.
Do you have a risk of type 2 diabetes? Let's try taking the assessment.
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1. What is your age?*

Below 35 years35 - 44 years45 - 49 years50 - 59 years60 years or over
How much do you weigh? (kilograms)*
How tall are you? (centimeters)*
Your Body Mass Index (BMI) (kg/m²)
2. What is your BMI (weight in kg/height in m2)?*

Below 23 kg/m223 kg/m2 - 27.49 kg/m227.5 kg/m2 or over
What is your waist circumference? (centimeters)*
Your waist-to-height ratio.*
3. What is your waist-to-height ratio?*

≤0.5>0.5 -0.6>0.6
4. Do you have high blood pressure?*

No (<120 mmHg)High blood pressure (120 mmHg - <140/90 mmHg)Severely high blood pressure (≥140/90 mmHg)
5. Do you have a first-degree relative(parents and siblings) with diabetes?*

NoYes
6. What is your fasting plasma glucose (FPG)?*

<100 mg/dL100 - 125 mg/dL
Score
You have completed the assessment!

Please provide your information to receive the results of the diabetes risk assessment.
Full name*

PrefixFirst nameLast name
Gender*

FemaleMale
Date of birth*

DayMonthYear
Email*

Confirmation Email
Phone number*
Should be Empty:

Complete the assessment to receive your type 2 diabetes risk evaluation.