Form: Device related physical activity and stress
Question | Response |
---|---|
Did the subject experience any unusual physical activity or stress because of wearing the device? | |
Did the subject any unusual physical activity or stress because of wearing the device? | |
Did the subject experience unusual physical activity? | |
Start date of unusual physical activity | |
Start time of unusual physical activity | |
Stop date of unusual physical activity | |
Stop time of unusual physical activity | |
Did the subject experience a stressful event? | |
Start date of stressful event | |
Start time of stressful event | |
Stop date of stressful event | |
Stop time of stressful event |
Form: Falls
Question | Response |
---|---|
Did the patient fall since last visit? | |
Date of fall | |
Time of the day | |
Environment (of fall) | |
Activity at the time of fall | |
Fall Mechanism | |
Did the fall result in injury | |
Severity of the injury | |
Form:
Question | Response |
---|---|
Did subject have any hypoglycemic events since the last visit? | |
Sequence Identifier | |
Hypoglycemic event start date | |
Hypoglycemic event start time | |
What was the date of last study treatment before the event? | |
What was the time of last study treatment before the event? | |
What was the subject's awareness of the hypoglycemic event? | |
Blood glucose concentration measured prior to treating the event? | |
If measured, what is the blood glucose concentration | |
Unit of blood glucose concentration measurement | |
Were signs/symptoms of hypoglycemia present, other than the blood glucose reading? | |
What was the hypoglycemic event outcome? | |
Specify if outcome is other | |
Was treatment given because of the occurrence of the event? | |
If yes, how was the hypoglycemic event treatment | |