Prediabetes Risk Test
Count the points you score on your fingers while filling out the risk test to keep track of your score.

Based on the CDC Prediabetes Risk Test
Have you been diagnosed with diabetes or prediabetes? *
Don't count any points for this question.
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 BMI category? *
You can calculate your BMI at http://tinyurl.com/adultBMIcalc or use the chart below to determine your weight category.
Captionless Image
How many points did you score? *
Count up the number of points you scored or the number of fingers you are holding up.
If you scored 5 or higher:
You are at increased risk for having prediabetes and are at high risk for type 2 diabetes. However, only your doctor can tell for sure if you have type 2 diabetes or prediabetes, a condition in which blood sugar levels are higher than normal but not high enough yet to be diagnosed as type 2 diabetes. Talk to your doctor to see if additional testing is needed.
If you are African American, Hispanic/Latino American, American Indian/Alaska Native, Asian American, or Pacific Islander, you are at higher risk for prediabetes and type 2 diabetes. Also, if you are Asian American, you are at increased risk for type 2 diabetes at a lower weight (about 15 pounds lower than weights in the 1 Point column). Talk to your doctor to see if you should have your blood sugar tested.

Visit the Healthy Washington County website to find resources to help you reduce your risk of type 2 diabetes. You will be given a link to the Healthy Washington County website after you click Submit.
If you scored 5 or higher on the risk test, would you be interested in being contacted to review some options for lowering your risk? *
Next
Never submit passwords through Google Forms.
This form was created inside of State of Maryland. Report Abuse