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["Follow-up record sheet"]
["Follow-up record sheet"]
["Patient ID:","Name:","Telephone number:"]
["Follow-up time:","Follow-up recorder:"]
["1. In the past year, have you visited again (including regional hospitals and clinics)?    1 No    2 Yes"]
["2. If yes, the name of the hospital and the date."]
["3. If you visited again, hospitalized or not?    1 No    2 Yes"]
["4. Are you regularly monitoring blood sugar?    1 No    2 Yes"]
["5. The most recent blood sugar level. (FPG/ PBG)"]
["6. Are you regularly monitoring blood pressure?    1 No    2 Yes"]
["7. The most recent blood pressure value. (SBP/DBP)"]
["8. Is there any foot damage (ulcer) or abnormal?    1 No    2 Yes     "]
["9. Whether to change your behavior according to the message content?"]
["    1 No    2 There are changes but not all done    3 Yes"]
["10. Are you focusing on your diet?    1 No    2 Moderate    3 Yes"]
["11. Your current changes in vegetable intake?    1 Decrease    2 Increase    3 No change"]
["12. Your current changes in fruit intake?    1 Decrease    2 Increase    3 No change"]
["13. Your current changes in weight ?    1 Decrease    2 Increase    3 No change"]
["14. Are you quitting smoking?    1 No    2 Yes"]
["15. Are you quitting drinking?     1 No    2 Yes"]
["16. Can you exercise 30-60 minutes a day, 3-5 times a week?     1 No    2 Yes"]
["17. Communication and willingness to cooperate."]
["    1 Not connected    2 Connected and matched    3 Connected and unmatched     "]
["18. Patient coordination.    1 Well    2 Middle    3 Bad   "]
["19. Remarks:"]