YMCA/UofL Diabetes Prevention Program

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Birth Date (Required)

Pre-Diabetes Self Assessment

In order to qualify for the program you need to be at a high risk for developing diabetes. As a self-assessment, please answer the following questions:

My blood pressure is 140/90 or higher, or I have been told I have high blood pressure.

I have been told that my cholesterol levels are not normal.

I am fairly inactive. I do NOT exercise more often than two times a week

I have or had a parent or a sibling with diabetes

I have had gestational diabetes (diabetes during pregnancy), or I gave birth to a baby weighing more than 9 pounds.

I am overweight (BMI ≥ 25 kg/m2)

I am 45 years of age or older.

I have been told I have pre-diabetes

Agreements (Required)

I agree to set-up an appointment with GHN for a Health Fitness Assessment (to determine blood sugar levels) or provide lab results from within the last six months.

I agree to pay the $50 enrollment fee to the YMCA

Select a class (Required)

Select a date/location below

HSC: Wednesdays, Feb 13- Jun 5, 12-12:45p.m., Location: Staff Performance and Development Classroom (basement of Parking Garage Building), Facilitator: Amber Barnes (UofL HealthCare, Wellness Dietitian

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