Inclusion Criteria:  UMMC patient within the previous 3-years (at least one UMMC clinical visit within the previous 3-years) ≥ 18 years AND Clinical diagnosis for prediabetes (R73.03)  OR any of the following combinations:  BMI ≥25 (non-Asian) OR BMI ≥23 (Asian) AND HbA1c 5.7 - 6.4 percent within the past 12-months OR Fasting plasma glucose 110 - 125 mg/dL within the past 12-months OR 2-hour plasma glucose 140 - 199 mg/dL within the past 12-months  Exclusion Criteria:  Pregnant or planning to become pregnant within the next 12 months <18 years Primary or secondary diagnosis of diabetes mellitus (all codes with prefix of 250 and 249) and other conditions associated with diabetes (357.2, all codes with prefix 362, 366.41, and all codes with prefix 648). End stage renal disease