What this questionnaire covers
Records diabetes treatment, regulation of activities, acute episodes, complications and functional effects. Related complications may require separate questionnaires.
Official instructions — page 1Diabetes Mellitus DBQ
Records diabetes treatment, regulation of activities, acute episodes, complications and functional effects. Related complications may require separate questionnaires.
Current public questionnaire
Download Diabetes Mellitus DBQUpdated 2026-03-16 · v26_1
Use the appropriate condition questionnaire; identify evidence reviewed, complete the applicable findings and examiner certification, and follow the condition-specific instructions below. A form response does not itself establish service connection or a percentage.
Examiner requirements
The PDF is intended for the Veteran’s health care provider. Its general wording does not itself resolve specialty, state scope-of-practice or VA privileging requirements. The PDF explicitly requires an ophthalmologist or optometrist for the related Eye Conditions questionnaire.
Instructions by section
Who completes it
The PDF is intended for the Veteran’s health care provider. Its general wording does not itself resolve specialty, state scope-of-practice or VA privileging requirements.
Official instructions — page 1Complications and related questionnaires
Selected condition-specific instructions; read the complete current official PDF for definitions, testing and remaining fields.
- Complete the applicable questionnaire for listed complications. The Eye Conditions questionnaire must be completed by an ophthalmologist or optometrist.
- Identify treatment, regulation of activities and acute episodes in the sections that apply to the diagnosed condition.
Identify the evidence reviewed
Identify the records reviewed and the date range. Answer the examination-method and clinical-relationship questions from what actually occurred.
Official instructions — page 1Complete the examiner’s certification
The examiner certifies that the information is accurate, complete and current. Complete the signature, date, specialty, contact, National Provider Identifier and medical-license fields requested on the original form.
Official instructions — page 6Review scope
Editorial comparison of this description and revision label with the original questionnaire; not full regulatory mapping or professional review.
Instruction comparison: 2026-10-04. Per-record provider-intent and certification passages compared; full text automatically scanned for examiner-role restrictions. Named mental-health restrictions and selected testing passages separately read. Not a complete clinical instruction or examiner-qualification audit.