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How old are you?
Less than 40 years (0 points)
40—49 years (1 point)
50—59 years (2 points)
60 years or older (3 points)
Are you a man or a woman?
Man (1 point) Woman (0 points)
If you are a woman, have you ever been
diagnosed with gestational diabetes?
Yes (1 point) No (0 points)
Do you have a mother, father, sister, or
brother with diabetes?
Have you ever been diagnosed with high
Are you physically active?
Yes (0 points) No (1 point)
What is your weight status?
(see chart at right)
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