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Were You A Type 2 Diabetic That Beat The Odds?

Were you diagnosed with Type 2 diabetes because of weight problems? Did you decide to get in shape and try to beat diabetes?

If you were once overweight and had Type 2 diabetes before losing weight, we want to hear from you!

first name:	*
last name:	*
birthday:	*
E-mail address:	*
street address:	*
additional address:
city:	*
state:	*
province/Region (if not in U.S.):
zip/Postal code:	*
country:	*
day phone:	*
evening phone:
cell phone:
are you willing to appear on the show:	Yes No *
children's ages?:

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