Prediabetes Risk Test



Assess your risk of prediabetes.

If you were referred by a health care provider please list that providers name and submit form.
How old are you?
Are you a man or a woman?
If you are a woman, have you ever been diagnosed with gestational diabetes?
Do you have a mother, father, sister, or brother with diabetes?
Have you ever been diagnosed with high blood pressure?
Are you physically active?
What is your weight category? (See chart below)
How many points do you have in total?


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