Inclusion Criteria:

• ≥ 50 years of age or older at the time of enrollment
• Willing to sign the informed consent form
• Must have 2 occurrences from among the below parameters of diabetes mellitus (PDMs) in past 90 days measured in outpatient setting (not in urgent care, emergency room or while inpatient):
• FBG ≥126mg/dl HbA1c ≥6.5% RBG ≥ 200mg/dl 2-hour post-glucose ≥200mg/dl (OGTT)
• Must have had glycemic parameter measured in 3-18 months prior to screening that did NOT meet DM criteria
• Must be willing to provide several tubes of blood without endangering health
• No history of pancreatic cancer or other known pancreatic neoplasia
• No active cancers within the past 5 years (with the exception of non-melanoma skin cancers resolved/treated \> 1 year prior to enrollment and in situ cancers)

Exclusion Criteria:

• Prior DM diagnosis
• Met criteria for DM ≥91 days prior to enrollment (patients with prior gestational diabetes that has resolved are NOT acceptable to enroll)
• Carried a DM diagnosis or used anti-DM medications at a time greater than or equal to 91 days prior to enrollment
• Any known pancreatic lesions (aside from diabetes)
• Received cancer treatment within the past 5 years (with the exception of treatment of non-melanoma skin cancer), carrying a current cancer diagnosis, and/or being investigated for suspicion of past cancer recurrence.
• Current chronic or acute oral steroid use
• History of intra-articular steroid injections (\<1 week) of the qualifying DM blood test (allowed exception: nasal, topical, oral budesonide)
• Any surgery requiring general anesthesia within 2 months of collection
• Local anesthetic (including dental novocaine) within 1 week of collection
• History or presence of HIV/AIDs, Hepatitis A or E within the past five years, TB, any kind of prion disorder (e.g., CJD)
• Blood transfusion within 1 month
• Organ transplant recipient
• Currently pregnant, or pregnancy within last 12 months
• Receipt of systemic immunomodulation therapy within past 12 months
• Significant medical condition that in the site investigator's opinion would compromise the subject's ability to tolerate study interventions