Context: It is not known to what extent the diagnosis of pre-diabetes is associated with improved patient health behaviors. Does knowledge of the diagnosis of pre-diabetes, alone, lead to improved A1c and decreased progression to diabetes? Specifically, the objective of this study are to observe the impact of notifying patients of a pre-diabetes diagnosis on lifestyle changes, and whether patients’ awareness of their diagnosis resulted in any improvements in the patient’s Hgb A1c and if there are any significant changes between men and women. Objective: To determine the clinical effect of informing patients in an academic medical center family medicine clinic of their pre-diabetic status, without other intensive prescribed interventions. Study design: retrospective cohort study. Setting or dataset: Academic medical center primary care clinic, data obtained using an electronic medical record. Population studied: inclusion criteria: Family Medicine Clinic patients who between 18 and 65 years of age, has a pre-diabetic status , and had a clinic visit during the year 2018. Exclusion criteria: AU Family Medicine Clinic patients <18 years of age, > 65, pregnant patients, on a medication for diabetic control (metformin), has a diagnosis, or has ever had a diagnosis of diabetes, does not have a follow-up appointment at the Family Medicine Clinic after 15 months of pre-diabetes diagnosis. Intervention/instrument: none. Observational study. We will compare patients that were notified of their pre-diabetes to those who were not notified of their pre-diabetes Outcome measures: BMI, HbA1c, progression to diabetes. Anticipated Results: there will be significant difference in the ΔHbA1C, Δweight, and percentage of patients informed of pre-diabetic status that progress to a diagnose of diabetes as compared to those not informed of pre-diabetic status after 1-year follow up. Expected Outcome: We do not expect to see a significant difference in the outcome among men versus women.