Diabetes Nutrition Impact Survey
Help us understand how nutrition habits influence the daily lives of people managing diabetes. Your feedback is anonymous and valuable.
Your age
*
Gender
*
Male
Female
Non-binary
Prefer not to say
How many meals do you typically eat per day?
*
Please Select
1
2
3
4 or more
How often do you include fresh fruits or vegetables in your meals?
*
At every meal
Once a day
A few times a week
Rarely
Which best describes your approach to carbohydrate intake?
*
I count carbohydrates at every meal
I try to limit carbohydrates overall
I do not pay close attention to carbohydrates
I'm not sure
How confident do you feel about making healthy food choices?
*
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
Have you made any recent changes to your diet for diabetes management?
*
Yes
No
If yes, please describe the changes you made.
What is your biggest challenge when it comes to nutrition and diabetes?
*
Would you like to receive updates or resources related to diabetes nutrition?
*
Yes, please email me
No, thank you
Submit Survey
Should be Empty: