TABLE 1.

Items From the DSRI

How often have you …  Guessed the number of carbs in a snack/meal you were eating when the nutrition information was right there?  Decided not to wear a diabetes ID?  Engaged in physical activity without wearing a diabetes ID?  Engaged in physical activity without first checking your blood glucose?  Participated in an organized sport or activity without telling the coach you have diabetes?  Ate without first checking your blood glucose?  Drunk anything besides water/diet drinks without first checking your blood glucose?  Felt your blood glucose might be low and did not check?  Felt your blood glucose might be low and did not treat it?  Had high blood sugars and did not check ketones?  Gone without checking your blood glucose for at least 24 hours?  Told someone you checked your blood glucose when you really had not?  Entered made-up blood glucose numbers in your logbook?  Reported a made-up blood glucose number to someone?  Taken insulin without checking your blood glucose first?  Ate without taking short-acting insulin to cover carbs (except when blood glucose is low)?  Drunk anything besides water without taking short-acting insulin to cover carbs?  Taken less insulin than you knew you needed, based on carbs, blood glucose, and exercise?  Taken more insulin than you knew you needed, based on carbs, blood glucose, and exercise?  Waited until you were out of insulin before telling your parents or getting more from the pharmacy?  Waited until your glucagon had expired before telling parents or getting more from the pharmacy?  Gone without taking insulin for at least 24 hours?  Told your parents you had taken insulin when you really had not?  Told your doctor you had taken insulin when you really had not?  Driven a car without first checking your blood glucose?  Driven a car without fast-acting carbs within reach?  Drunk alcohol without eating extra carbs?  Drunk alcohol when no one around knew you had diabetes?  Drunk alcohol without wearing a diabetes ID?  Gone to sleep after drinking alcohol with no plan for checking blood sugars during the night?  Gotten drunk to the point where you could not take care of your diabetes?  Used drugs (for example, pills that were not prescribed to you, marijuana, etc.) when no one around knew you had diabetes?  Had sex without first checking your blood glucose?  Gone to sleep after sex without checking blood glucose?