233 lines
6.9 KiB
Markdown
233 lines
6.9 KiB
Markdown
# Home Insulin Sensitivity Self‑Test Protocol
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> **Purpose**
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> 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.
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> It approximates what a careful clinician could infer from dynamic testing, not just single lab values.
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---
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## General Rules (Apply to All Days)
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* Use the **same glucose meter** throughout
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* Wash hands with warm water; dry thoroughly
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* Use the **same finger** when possible
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* Record sleep quality, stress, illness, alcohol, or poor sleep
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* Avoid alcohol for the entire protocol
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* Avoid unusual training or dieting
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All glucose values below are expressed in **mg/dL**.
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---
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## Overview of the 5‑Day Structure
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* **Day 1:** Baseline + hepatic (fasting) stress test
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* **Day 2:** Standard glucose challenge (dynamic insulin response)
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* **Day 3:** Exercise‑mediated glucose uptake
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* **Day 4:** Clean control day (true baseline)
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* **Day 5:** Repeatability / variance check
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---
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## DAY 1 — Baseline + Hepatic Stress Test
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**Physiology tested:**
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Basal insulin tone and hepatic glucose output under mild fasting stress.
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**Procedure**
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1. Wake and measure glucose within 15 minutes (fasted)
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2. Consume only water, black coffee, or tea
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3. Remain fasted for **3–4 hours**
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4. Measure glucose **immediately before lunch**
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5. Eat lunch normally
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6. Eat an **early dinner** (≥3 hours before bed)
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7. Measure glucose **before bed**
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---
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## DAY 2 — Standard Glucose Challenge
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**Physiology tested:**
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First‑phase insulin response, peak handling, and glucose clearance.
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**Preparation**
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* 8–12 hour overnight fast
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* No exercise, caffeine, or nicotine beforehand
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**Glucose solution**
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* Dissolve **75 g table sugar (sucrose)** in 250–300 ml warm water
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* Drink completely within **5 minutes**
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**Procedure**
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1. Measure fasting glucose (T0)
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2. Immediately drink glucose solution
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3. Measure glucose at:
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* **30 minutes**
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* **60 minutes**
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* **120 minutes**
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4. Eat early dinner
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5. Measure glucose before bed
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---
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## DAY 3 — Exercise Uptake Test
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**Physiology tested:**
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Insulin‑independent muscle glucose uptake vs stress response.
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**Procedure**
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1. Measure fasting glucose
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2. Perform **60 minutes steady jog** (conversational pace, not maximal)
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3. Measure glucose **immediately after exercise**
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4. Remain fasted
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5. Measure glucose **60 minutes post‑exercise**
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6. Eat early dinner
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7. Measure glucose before bed
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---
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## DAY 4 — Clean Control Day
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**Physiology tested:**
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Unstressed baseline glucose regulation.
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**Procedure**
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1. Measure fasting glucose
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2. Eat normally (no fasting extension)
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3. No intense exercise
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4. Eat early dinner
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5. Measure glucose before bed
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---
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## DAY 5 — Repeatability / Variance Check
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**Physiology tested:**
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Stability and robustness of glucose regulation.
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**Procedure**
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1. Measure fasting glucose
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2. Normal day
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3. Eat early dinner
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4. Measure glucose before bed
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---
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# Interpretation Table
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The table below lists **each reading**, the **expected value ranges**, and **their physiological meaning**.
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---
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## Fasting Glucose (Morning)
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| Value | Category | Meaning |
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| ------- | ---------- | ---------------------------- |
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| 70–85 | Excellent | High insulin sensitivity |
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| 86–92 | Good | Normal metabolic health |
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| 93–99 | Borderline | Early insulin resistance |
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| 100–109 | Poor | Hepatic insulin resistance |
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| ≥110 | Concerning | Likely chronic dysregulation |
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---
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## Delayed‑Meal (Day 1, Pre‑Lunch)
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| Change vs morning | Category | Meaning |
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| ----------------- | ---------- | ----------------------------- |
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| Stable or ↓ | Excellent | Hepatic insulin sensitivity |
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| +1–10 | Acceptable | Normal stress response |
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| +11–20 | Poor | Hepatic insulin resistance |
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| >20 | Concerning | Stress‑driven glucose dumping |
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---
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## Glucose Challenge — 30 min (Early Spike)
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| Rise from fasting | Category | Meaning |
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| ----------------- | --------- | --------------------------- |
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| ≤30 | Excellent | Strong first‑phase insulin |
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| 31–50 | Normal | Adequate response |
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| 51–70 | Weak | Delayed insulin secretion |
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| >70 | Poor | Loss of first‑phase insulin |
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---
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## Glucose Challenge — Peak (30–60 min)
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| Peak value | Category | Meaning |
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| ---------- | --------- | -------------------------- |
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| <130 | Excellent | Strong insulin sensitivity |
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| 130–139 | Good | Normal |
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| 140–159 | Impaired | Reduced sensitivity |
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| ≥160 | Poor | Insulin resistance |
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---
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## Glucose Challenge — 120 min (Clearance)
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| 120‑min value | Category | Meaning |
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| ------------- | ---------- | ----------------------- |
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| ≤ fasting +10 | Excellent | Rapid glucose clearance |
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| ≤120 | Acceptable | Normal clearance |
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| 121–139 | Impaired | Slow clearance |
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| ≥140 | Poor | Pathologic response |
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---
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## Post‑Exercise (Immediate)
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| Pattern | Category | Meaning |
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| ----------- | ---------- | -------------------------- |
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| ↓ or stable | Excellent | Strong muscle uptake |
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| Mild ↑ | Acceptable | Balanced response |
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| Large ↑ | Poor | Stress‑dominant physiology |
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---
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## Post‑Exercise (+60 min)
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| Pattern | Category | Meaning |
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| ----------------------- | --------- | ------------------------ |
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| Lower than pre‑exercise | Excellent | High insulin sensitivity |
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| Back to baseline | Good | Normal recovery |
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| Elevated | Poor | Metabolic inflexibility |
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---
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## Evening → Morning Drift
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| Morning vs bedtime | Category | Meaning |
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| ------------------ | --------- | ------------------------- |
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| Same or lower | Excellent | Stable nocturnal control |
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| +5–10 | Normal | Mild dawn effect |
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| +11–20 | Impaired | Nocturnal resistance |
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| >20 | Poor | Significant dysregulation |
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---
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## Day‑to‑Day Variance (Fasting)
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| Variability | Category | Meaning |
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| ----------- | --------- | --------------------------- |
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| ≤5 | Excellent | Robust system |
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| 6–10 | Normal | Mild variability |
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| >10 | Fragile | Stress‑sensitive metabolism |
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---
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## Final Integration Rule
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* **Mostly Excellent / Good:** Insulin sensitive, metabolically flexible
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* **Mixed Results:** Early, reversible insulin resistance
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* **Multiple Poor / Concerning:** Established insulin resistance
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> **Key principle:** insulin sensitivity is revealed by *behavior across conditions*, not a single number.
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