In the first years of a campaign to raise awareness about prediabetes, the Ad Council and its partners used humor in their public service advertisements.

In 2016, one video featured three men sitting around a table eating spaghetti as the narrator says that one in three adults have prediabetes.

“That means it could be you, your favorite brother, your other brother,” the ad continues. 

After 20 months of upheaval due to COVID-19 pandemic, the people behind the campaign, which launched in 2016, decided to take a more serious approach in their latest video

“With the backdrop of COVID, we just didn’t feel that humor in the film was going to work as well,” said Heidi Arthur, chief campaign development officer at the Ad Council, a nonprofit advertising group.

The new video, which debuted on October 25, is set in an aquarium and features a man taking a selfie in front of a shark tank. He notices that the glass behind him has cracked. 

“Life doesn’t always give you time to change the outcome,” warns the narrator. “Prediabetes does.”

The shark then smashes through the glass as the narrator shares data about the prevalence of prediabetes and urges people to learn whether they might have the condition by taking a one-minute test at

“With early diagnosis, prediabetes can be reversed,” the narrator continues as the glass and shark are rewound back into place.

The Ad Council developed the Do I Have Prediabetes? campaign in partnership with the American Medical Association and the Centers for Disease Control and Prevention, which provided $1.2 million and $1.3 million, respectively, for the push. 

The CDC defines prediabetes as “a serious health condition where blood-sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes.”

In 2005, only about 7% of people with prediabetes were aware they had it, according to a CDC report. Eighty-eight million American adults have the condition, according to the agency’s most recent figures.

Arthur said the campaign has increased awareness of the condition. 

Since it launched in January 2016, the campaign has received $141 million in donated media and 4.24 million unique visitors have visited the campaign website, according to the Ad Council.

Creative agencies Grey New York and Wordsworth + Booth worked pro bono on the campaign.

The spots, which were produced in English and Spanish, will appear in donated time and space nationwide in TV, online video, print, radio, out-of-home and digital banners, with significant donated media provided by Facebook and YouTube, the release states.

Arthur said the creatives also took a more serious approach because people with chronic conditions such as diabetes face greater risk from COVID-19. Nearly 40% of COVID-19 deaths were people with diabetes in Alabama, Louisiana, Mississippi, North Carolina, South Carolina and West Virginia, according to a Reuters report

“We don’t want to overwhelm people; we don’t want to blame them and wag the finger,” Arthur said. “We want them to relate to it, to see themselves as personally at risk and found this year that for the film and the message itself, we needed to dial up the sense of urgency.”

This article originally appeared on PRWeek US.