Prediabetes Risk Test

How old are you?*

Younger than 40 years (0 points)40-49 years (1 point)50-59 years (2 points)60 years or older (3 points)

What was your sex assigned at birth?*

Male (1 point)Female (0 points)

If assigned female at birth, have you ever been diagnosed with gestational diabetes?

Yes (1 point)No (0 points)

Do you have a parent or sibbling 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. 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

If you scored 5 or higher:

You're likely to have prediabetes and are at high risk for developing type 2 diabetes. However, only your doctor can tell you for 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 information below before you click submit.

Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

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?*

DaysNightsEither is fine

What type of insurance do you have?*

MedicareMedicaidI don't have insurancePrivate insurance

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

I have diabetesI have prediabetesI do not have diabetes or prediabetesI do not know my status