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Survey Form

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  • * 1. Demographic Details

  • 2. Date of birth (dd/mm/yyyy)

  • 3. Date of Diagnosis (dd/mm/yyyy)

  • * 4. I am

  • Behaviour: Below is a list of things people might do in order to avoid low blood glucose. Read each item carefully (do not skip any). Select one of the options that best describes what you do during the evening/night to avoid night-time hypos.

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