The Centers for Disease Control and Prevention (CDC) and the Agency for Healthcare Research and Quality (AHRQ) are pleased to release this report, Women at High Risk for Diabetes: Access and Quality of Health Care, 2003-2006, on behalf of the U.S. Department of Health and Human Services (HHS). This collaboration examined the quality of preventive health care received by U.S. women at high risk and not at high risk for diabetes, using the most scientifically based measures and national data sources available. The report presents measures of health care quality showing the use of services in several areas: access to care, general health and well-being, and preventive care and behaviors. Diabetes is a chronic disease that is very common, serious, and costly. Diabetes can lead to serious complications, such as heart disease and stroke, high blood pressure, blindness, and kidney disease. However, people with diabetes can control the disease and reduce their likelihood of developing complications. An estimated 24 million people in the United States, or 8% of those age 20 years and over, have diabetes; of those, almost half are women. At least one-fourth of adults in the United States are also known to have prediabetes, a condition in which people have blood glucose levels higher than normal but not high enough to be diagnosed with diabetes. People with prediabetes have an increased risk of type 2 diabetes, heart disease, and stroke. Women are more likely than men to develop chronic diseases, such as diabetes, and to suffer disproportionately from disability compared to men. It is important to target women at high risk for diabetes for intervention to reduce their risk of diabetes. Evidence shows that people with prediabetes who lose 5 to 7% of their body weight and increase their physical activity can prevent or delay diabetes. Early interventions and access to preventive care services are important for women to reduce the risk of developing other diseases, such as cardiovascular disease. However, very few studies have examined preventive care measures for women at high risk for diabetes. To address this gap, CDC collaborated with AHRQ to develop this report, which assesses and describes the quality of care that women at high risk for diabetes receive in the United States. This report can be used to identify areas in which intervention can help women at high risk for diabetes across the lifespan, and to focus attention on possible gaps in public health programs, policies, research, and surveillance. Similar to the 2008 report, Women With Diabetes: Quality of Health Care, 2004-2005, this report analyzes a wide variety of measures selected by experts at CDC and AHRQ as highly relevant to an examination of the quality of health care for women at high risk for diabetes. Due to data availability and other constraining factors, the measures discussed in this report are not necessarily comprehensive. Still, they highlight important areas of health care quality of particular relevance to women at high risk for diabetes. Throughout the report, the comparison groups are: Women at high risk for diabetes; Women not at high risk for diabetes.