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# Home Insulin Sensitivity SelfTest Protocol
> **Purpose**
> This protocol is designed to evaluate insulin sensitivity, glucose regulation, metabolic flexibility, and physiological robustness using **only fingerstick blood glucose measurements** and strong adherence to instructions.
> It approximates what a careful clinician could infer from dynamic testing, not just single lab values.
---
## General Rules (Apply to All Days)
* Use the **same glucose meter** throughout
* Wash hands with warm water; dry thoroughly
* Use the **same finger** when possible
* Record sleep quality, stress, illness, alcohol, or poor sleep
* Avoid alcohol for the entire protocol
* Avoid unusual training or dieting
All glucose values below are expressed in **mg/dL**.
---
## Overview of the 5Day Structure
* **Day 1:** Baseline + hepatic (fasting) stress test
* **Day 2:** Standard glucose challenge (dynamic insulin response)
* **Day 3:** Exercisemediated glucose uptake
* **Day 4:** Clean control day (true baseline)
* **Day 5:** Repeatability / variance check
---
## DAY 1 — Baseline + Hepatic Stress Test
**Physiology tested:**
Basal insulin tone and hepatic glucose output under mild fasting stress.
**Procedure**
1. Wake and measure glucose within 15 minutes (fasted)
2. Consume only water, black coffee, or tea
3. Remain fasted for **34 hours**
4. Measure glucose **immediately before lunch**
5. Eat lunch normally
6. Eat an **early dinner** (≥3 hours before bed)
7. Measure glucose **before bed**
---
## DAY 2 — Standard Glucose Challenge
**Physiology tested:**
Firstphase insulin response, peak handling, and glucose clearance.
**Preparation**
* 812 hour overnight fast
* No exercise, caffeine, or nicotine beforehand
**Glucose solution**
* Dissolve **75 g table sugar (sucrose)** in 250300 ml warm water
* Drink completely within **5 minutes**
**Procedure**
1. Measure fasting glucose (T0)
2. Immediately drink glucose solution
3. Measure glucose at:
* **30 minutes**
* **60 minutes**
* **120 minutes**
4. Eat early dinner
5. Measure glucose before bed
---
## DAY 3 — Exercise Uptake Test
**Physiology tested:**
Insulinindependent muscle glucose uptake vs stress response.
**Procedure**
1. Measure fasting glucose
2. Perform **60 minutes steady jog** (conversational pace, not maximal)
3. Measure glucose **immediately after exercise**
4. Remain fasted
5. Measure glucose **60 minutes postexercise**
6. Eat early dinner
7. Measure glucose before bed
---
## DAY 4 — Clean Control Day
**Physiology tested:**
Unstressed baseline glucose regulation.
**Procedure**
1. Measure fasting glucose
2. Eat normally (no fasting extension)
3. No intense exercise
4. Eat early dinner
5. Measure glucose before bed
---
## DAY 5 — Repeatability / Variance Check
**Physiology tested:**
Stability and robustness of glucose regulation.
**Procedure**
1. Measure fasting glucose
2. Normal day
3. Eat early dinner
4. Measure glucose before bed
---
# Interpretation Table
The table below lists **each reading**, the **expected value ranges**, and **their physiological meaning**.
---
## Fasting Glucose (Morning)
| Value | Category | Meaning |
| ------- | ---------- | ---------------------------- |
| 7085 | Excellent | High insulin sensitivity |
| 8692 | Good | Normal metabolic health |
| 9399 | Borderline | Early insulin resistance |
| 100109 | Poor | Hepatic insulin resistance |
| ≥110 | Concerning | Likely chronic dysregulation |
---
## DelayedMeal (Day 1, PreLunch)
| Change vs morning | Category | Meaning |
| ----------------- | ---------- | ----------------------------- |
| Stable or ↓ | Excellent | Hepatic insulin sensitivity |
| +110 | Acceptable | Normal stress response |
| +1120 | Poor | Hepatic insulin resistance |
| >20 | Concerning | Stressdriven glucose dumping |
---
## Glucose Challenge — 30 min (Early Spike)
| Rise from fasting | Category | Meaning |
| ----------------- | --------- | --------------------------- |
| ≤30 | Excellent | Strong firstphase insulin |
| 3150 | Normal | Adequate response |
| 5170 | Weak | Delayed insulin secretion |
| >70 | Poor | Loss of firstphase insulin |
---
## Glucose Challenge — Peak (3060 min)
| Peak value | Category | Meaning |
| ---------- | --------- | -------------------------- |
| <130 | Excellent | Strong insulin sensitivity |
| 130139 | Good | Normal |
| 140159 | Impaired | Reduced sensitivity |
| ≥160 | Poor | Insulin resistance |
---
## Glucose Challenge — 120 min (Clearance)
| 120min value | Category | Meaning |
| ------------- | ---------- | ----------------------- |
| ≤ fasting +10 | Excellent | Rapid glucose clearance |
| ≤120 | Acceptable | Normal clearance |
| 121139 | Impaired | Slow clearance |
| ≥140 | Poor | Pathologic response |
---
## PostExercise (Immediate)
| Pattern | Category | Meaning |
| ----------- | ---------- | -------------------------- |
| ↓ or stable | Excellent | Strong muscle uptake |
| Mild ↑ | Acceptable | Balanced response |
| Large ↑ | Poor | Stressdominant physiology |
---
## PostExercise (+60 min)
| Pattern | Category | Meaning |
| ----------------------- | --------- | ------------------------ |
| Lower than preexercise | Excellent | High insulin sensitivity |
| Back to baseline | Good | Normal recovery |
| Elevated | Poor | Metabolic inflexibility |
---
## Evening → Morning Drift
| Morning vs bedtime | Category | Meaning |
| ------------------ | --------- | ------------------------- |
| Same or lower | Excellent | Stable nocturnal control |
| +510 | Normal | Mild dawn effect |
| +1120 | Impaired | Nocturnal resistance |
| >20 | Poor | Significant dysregulation |
---
## DaytoDay Variance (Fasting)
| Variability | Category | Meaning |
| ----------- | --------- | --------------------------- |
| ≤5 | Excellent | Robust system |
| 610 | Normal | Mild variability |
| >10 | Fragile | Stresssensitive metabolism |
---
## Final Integration Rule
* **Mostly Excellent / Good:** Insulin sensitive, metabolically flexible
* **Mixed Results:** Early, reversible insulin resistance
* **Multiple Poor / Concerning:** Established insulin resistance
> **Key principle:** insulin sensitivity is revealed by *behavior across conditions*, not a single number.