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What is your gender?
 
Male
 
Female
 
 
 
What is your age?
 
20-25
 
26-30
 
31-35
 
36-40
 
41-45
 
> 46
 
 
 
What is your race/ethnicity?
 
African American
 
Latino
 
White
 
 
 
Do you have a first-degree relative with diabetes?
 
Yes
 
No
 
 
 
If you are a female, do you have a history of PCOS or Gestational Diabetes?
 
Yes
 
No
 
 
 
What is your height?
   
 
 
 
What is your weight?
   
 
 
 
Do you have a history or are you on any type of therapy for high blood pressure?
 
Yes
 
No
 
 
 
Do you have a history of high cholesterol or high triglycerides?
 
Yes
 
No
 
 
 
Do you have a history of cardiovascular disease?
 
Yes
 
No
 
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