DIABETES EVALUATION

Take this test to see if you are at risk for having diabetes. Diabetes is more common in African Americans, Latinos, Native Americans, Asian Americans, and Pacific Islanders. If you are a member of one of these ethnic groups, you need to pay special attention to this test.

1. I am a woman who has had a baby weighing more than nine pounds at birth.

Yes
No

2. I have a sister or brother with diabetes.

Yes
No

3. I have a parent with diabetes.

Yes
No

4. My weight is equal to or above that listed in the chart to the right.

Yes
No

5. I am under 65 years of age and I get little or no exercise.

Yes
No

6. I am between 45 and 64 years of age.

Yes
No

7. I am 65 years old or older.

Yes
No

8. What is your zip code? (Optional)