A Shared Decision Making Intervention for Diabetes Prevention in Women With a History of Gestational Diabetes Mellitus

Inclusion Criteria: * 18 years to 54 (Adult) * Females * Most recent BMI ≥25 kg/m2 (or \>23 if Asian American) * History of gestational diabetes mellitus based on: * Diagnostic code ICD10 or 1-hour glucose challenge test \> 140 mg/dL, followed by 3-hour glucose tolerance test with TWO or more values. Cut-offs \>= i. 95 at 0-hour ii. 180 at 1-hour iii. 155 at 2-hour iv. 140 at 3-hour * History of prediabetes in prior 36 months defined by either 1. most recent HbA1c 5.7-6.4% or 2. most recent FPG 100-125 mg/dL or 3. prior diabetes diagnostic codes + abnormal labs * Patient at UCLA or Intermountain Healthcare Systems with provider visit or labs in prior 12 months Exclusion Criteria: * Delivery within the last 12 months at randomization * History of diabetes (i.e., prior HbA1c 6.5% or above, or 2 or more fasting plasma glucose 125 or above, or prior diagnostic code) * Any anti-glycemic medications or insulin use 12 months prior to randomization * Most recent eGFR \<45 ml/min * BMI \>60 kg/m2 at randomization * History of any type of weight loss surgery 12 months prior to randomization * Currently being treated for an eating disorder, such as anorexia or bulimia * Currently pregnant or planning to get pregnant in the next 12 months * Completed a prior prediabetes SDM consult anytime * Currently enrolled OR have ever participated in any CDC certified Diabetes Prevention Program (DPP) * Inability or concerns about doing \>150 minutes of physical activity per week Currently taking a medication called metformin or have been prescribed metformin in the last 12-months * History of metformin intolerance * Unable to attend 3 virtual or in-person visits over the next 2 years at UCLA or Intermountain Healthcare * Non-English primary language