The goal of this clinical trial is to learn if knowing risk for diabetes can help adult patients with prediabetes take steps to get care and prevent diabetes. The main questions it aims to answer are:

• Does a shared-decision making visit with a health care team member to talk about the participant's diabetes risk increase participants' taking steps to prevent diabetes?
• Does a simple message in the patient portal about the participant's diabetes risk increase participants' taking steps to prevent diabetes?

Researchers will compare the visit with usual care at the clinic to see if the visit increases participants' taking steps to prevent diabetes. Separately, the researchers will compare the patient message with usual care at the clinic to see if the message increases participants' taking steps to prevent diabetes.

Participants will:

• Complete surveys at the beginning of the study and up to 2 additional surveys
• If the participant falls into the shared decision-making group, the participant will have one 30-minute visit with a healthcare team member to talk about risk of diabetes and how to lower it.

Inclusion Criteria:

• prediabetes based on most recent HbA1c (5.7-6.4%) or fasting plasma glucose (100-125 mg/dL) in prior 12 months
• active patient portal account (MyChart)
• patient receiving primary care at Johns Hopkins Community Physicians in Frederick
• have overweight or obesity (BMI ≥ 25 kg/m2)

Exclusion Criteria:

• have diabetes (HbA1c > 6.4% in prior 6 months or on diabetes registry)
• have dementia
• previously participated in the Diabetes Prevention Program (DPP)

Only de-identified IPD used in the results publication will be shared

Beginning 1 year after publication with no end date

All de-identified datasets that can be shared will be deposited in figshare, an open access ADA-approved repository.