Diabetic Reversing Tool Kit

Diabetic Reversing Programme for Type 2 Diabetes:
Self-Monitoring Tool Kit (105) days.
www.theinspireddiabetic.com

Name: 3334444444444555555555566666666667

Gender 7890123456789012345678901234567890

Age

Week 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 34567123456

Commenc

ing

Date:

Breakfast

Meal

Plan

Number:

Calorifc

Value

Lunch

Meal

Plan

Number:

Calorifc

Value

Tea

Meal

Plan

Number:

Calorifc

Value

Supper

Meal

Plan

Number:

Calorifc

Value

Diabetic Reversing Programme for Type 2 Diabetes:
Self-Monitoring Tool Kit (105) days.

Name: 71 7 7 7 7 7 7 7 7 8 8 8 8 8 8 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102

Gender: 2 3 4 5 6 7 8 9 0 1 2 3 4 5 103 104 105

Age:

Week 1 23456712345671

Commenc

ing

Date:

Breakfast
Meal
Plan
Number:
Calorifc
Value

Lunch
Meal
Plan
Number:
Calorifc
Value

Tea
Meal
Plan
Number:
Calorifc
Value

Supper
Meal
Plan
Number:
Calorifc
Value

Date Completion(105 days).

Why your GP monitors your blood glucose? : For people without diabetes, Refection and Review:
the normal range for the haemoglobin A1c(HbA1c ) to diagnosed diabetes level Prior to completing the Revising Diabetes Programme . What was your
HbAIc blood glucose level: Please state:……………………………What is
it Now?....................
Prior to completing the Revising Diabetes Programme: What was your
weight?
Please state……………………………….What is it
Now?..............................................
Prior to completing the Revising Diabetes Programme: What was your
cholesterol Level: Please state:……………………………….What is it
Now?...........................
Prior to completing the Revising Diabetes Programme: What was your
Blood Pressure Measurement: Please state:
……………………………….What is it Now?..........................
Prior to completing the Revising Diabetes Programme : What was your
Waist circumference measurement Please state:
………………………….What is it Now?................
Would you be interested in participating in research to evaluate the
programme? Yes/No. Please tick your answer:
I consent to be contacted by email Yes/No. If Yes. Please provide your
email address.
……………………………………………………………………………….