Diabetes is a growing national health problem.  Over 30 million Americans  have diabetes, representing 9.4% of the US population.  An additional 84 million Americans have prediabetes, a risk factor for developing diabetes in the future.  It is estimated that one-third of adults over 18 years of age have prediabetes, 70% of whom will eventually go on to develop diabetes according to an American Diabetes Association expert panel.

Diabetes results in significant morbidity with its associated human and financial costs.  It is the 7th leading cause of death in the US, and  people with diabetes are at increased risk of vision loss, heart disease, stroke, kidney failure, and amputation of toes, feet, or legs.  Vulnerable populations with less access to social, environmental, informational and healthcare resources bear a disproportionate portion of this burden.

To change the trajectory of diabetes prevalence in the United States, diabetes risk screening and early intervention prior to onset of diabetes is essential.  Prediabetes can be detected through simple screening tests.  An evidence-based lifestyle change program, the Diabetes Prevention Program, reduces the risk for developing type 2 diabetes in people with prediabetes by an average of 58%  in those with weight loss of 5 – 7% of body weight.  The Diabetes Prevention Program was adapted for translation into communities as the National Diabetes Prevention Program.  Despite outreach efforts to provide increased programming, many areas do not have access to the National DPP and many at-risk groups are underrepresented in these programs. The Cooperative Extension System (CES) has the potential to meet this need through its vast reach and mission to bring knowledge and skills to communities to improve health and well-being.