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insuline_sensitivity_testing/insuline_sensitivity_self_assessment.md

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+# Home Insulin Sensitivity Self‑Test Protocol
+
+> **Purpose**
+> This protocol is designed to evaluate insulin sensitivity, glucose regulation, metabolic flexibility, and physiological robustness using **only finger‑stick 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 5‑Day Structure
+
+* **Day 1:** Baseline + hepatic (fasting) stress test
+* **Day 2:** Standard glucose challenge (dynamic insulin response)
+* **Day 3:** Exercise‑mediated 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 **3–4 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:**
+First‑phase insulin response, peak handling, and glucose clearance.
+
+**Preparation**
+
+* 8–12 hour overnight fast
+* No exercise, caffeine, or nicotine beforehand
+
+**Glucose solution**
+
+* Dissolve **75 g table sugar (sucrose)** in 250–300 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:**
+Insulin‑independent 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 post‑exercise**
+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                      |
+| ------- | ---------- | ---------------------------- |
+| 70–85   | Excellent  | High insulin sensitivity     |
+| 86–92   | Good       | Normal metabolic health      |
+| 93–99   | Borderline | Early insulin resistance     |
+| 100–109 | Poor       | Hepatic insulin resistance   |
+| ≥110    | Concerning | Likely chronic dysregulation |
+
+---
+
+## Delayed‑Meal (Day 1, Pre‑Lunch)
+
+| Change vs morning | Category   | Meaning                       |
+| ----------------- | ---------- | ----------------------------- |
+| Stable or ↓       | Excellent  | Hepatic insulin sensitivity   |
+| +1–10             | Acceptable | Normal stress response        |
+| +11–20            | Poor       | Hepatic insulin resistance    |
+| >20               | Concerning | Stress‑driven glucose dumping |
+
+---
+
+## Glucose Challenge — 30 min (Early Spike)
+
+| Rise from fasting | Category  | Meaning                     |
+| ----------------- | --------- | --------------------------- |
+| ≤30               | Excellent | Strong first‑phase insulin  |
+| 31–50             | Normal    | Adequate response           |
+| 51–70             | Weak      | Delayed insulin secretion   |
+| >70               | Poor      | Loss of first‑phase insulin |
+
+---
+
+## Glucose Challenge — Peak (30–60 min)
+
+| Peak value | Category  | Meaning                    |
+| ---------- | --------- | -------------------------- |
+| <130       | Excellent | Strong insulin sensitivity |
+| 130–139    | Good      | Normal                     |
+| 140–159    | Impaired  | Reduced sensitivity        |
+| ≥160       | Poor      | Insulin resistance         |
+
+---
+
+## Glucose Challenge — 120 min (Clearance)
+
+| 120‑min value | Category   | Meaning                 |
+| ------------- | ---------- | ----------------------- |
+| ≤ fasting +10 | Excellent  | Rapid glucose clearance |
+| ≤120          | Acceptable | Normal clearance        |
+| 121–139       | Impaired   | Slow clearance          |
+| ≥140          | Poor       | Pathologic response     |
+
+---
+
+## Post‑Exercise (Immediate)
+
+| Pattern     | Category   | Meaning                    |
+| ----------- | ---------- | -------------------------- |
+| ↓ or stable | Excellent  | Strong muscle uptake       |
+| Mild ↑      | Acceptable | Balanced response          |
+| Large ↑     | Poor       | Stress‑dominant physiology |
+
+---
+
+## Post‑Exercise (+60 min)
+
+| Pattern                 | Category  | Meaning                  |
+| ----------------------- | --------- | ------------------------ |
+| Lower than pre‑exercise | 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  |
+| +5–10              | Normal    | Mild dawn effect          |
+| +11–20             | Impaired  | Nocturnal resistance      |
+| >20                | Poor      | Significant dysregulation |
+
+---
+
+## Day‑to‑Day Variance (Fasting)
+
+| Variability | Category  | Meaning                     |
+| ----------- | --------- | --------------------------- |
+| ≤5          | Excellent | Robust system               |
+| 6–10        | Normal    | Mild variability            |
+| >10         | Fragile   | Stress‑sensitive 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.