MDPP: Are You At Risk of Prediabetes?

The Wellness Coalition offers no-cost wellness classes covered by Medicare to help prevent type 2 diabetes and other chronic diseases. Simply answer the questions below to see your risk. Then submit your responses, and we will contact you about our program!
How old are you?

Less than 40 years (0 points)40-49 years (1 point)50-59 years (2 points)60 years or older (3 points)
Are you a man or a woman?

Man (1 point)Woman (0 points)
If you are a woman, have you ever been diagnosed with gestational diabetes?

Yes (1 point)No (0 points) - Select if you are a man
Do you have a mother, father, sister, or brother with diabetes?

Yes (1 point)No (0 points)
Have you ever been diagnosed with high blood pressure?

Yes (1 point)No (0 points)
Are you physically active?

Yes (0 points)No (1 point)
Look at the chart below. Find your height, then your weight range. Then, move to the bottom of the chart to see your points. How many points does this chart say for your height and weight?

0 points - my weight was lower than what is listed for my height1 point2 points3 points
Your Score:
Add up all your points from all the questions and put your total number here:
If you scored 5 or higher:

You're likely to have prediabetes and are at high risk of developing type 2 diabetes. However, only your doctor can tell for you sure if you have type 2 diabetes or prediabetes (a condition that preceded type 2 diabetes in which blood glucose levels are higher than normal). Talk to your doctor to see if additional testing is needed.

If you would like to be contacted about one of our no-cost prediabetes classes, please enter your contact information below before you click submit.
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please select your age range*

18-6465+
Would you prefer to attend classes in-person or virtually?*

In-personVirtuallyEither is fine
Do day or night classes work better for you?*

DayNightEither is fine
This program is being offered to help prevent diabetes in our community. Please select an option below to help determine eligibility.

I have diabetesI have prediabetesI do not have diabetes or prediabetesI do not know my status
Should be Empty: