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Select the program option that best matches what you want to enroll in.
Are you currently enrolled in Medicare Part B through original Medicare (fee-for-service) or a Medicare Advantage plan?
Within the last 90 days or last 12 months, do you have a fasting plasma glucose result of 110-125 mg/dL, an oral glucose tolerance test result of 140-199 mg/dL, or an HbA1C result of 5.7-6.4%?
Gestational diabetes is acceptable for this screening question.
This diagnosis affects eligibility for the diabetes prevention program.
A family history of diabetes could contribute to your risk for type 2 diabetes.
Having high blood pressure contributes to your overall risk for type 2 diabetes.
You are at a higher risk for type 2 diabetes the older you are.
People of certain racial and ethnic groups are more likely to develop type 2 diabetes than others. This also helps apply the CDC BMI threshold for Asian American participants.
Being inactive can increase your risk for type 2 diabetes.
Men are more likely than women to have undiagnosed diabetes. Women who had gestational diabetes also have increased risk later in life.
Have you ever been diagnosed with gestational diabetes?
The combination of your weight and height lets us know your Body Mass Index or BMI. People with higher BMIs are at a higher risk.
Points for each risk factor are added up to calculate your score. A total score of 5 or higher is considered high risk for having prediabetes.
Select one delivery option before continuing to the DPP enrollment form.
Save the complete result and scoring guide to your device.
Send the result as a PDF attachment to your email address.
Your PDF result is ready. Select OK to continue to the DPP enrollment form.
