Insulin Resistance Assessment

Based upon your health profile for the past 30 days, please select the appropriate number, from ‘0 – 3’ on all questions. Check the number you feel best applies, then add the total number from each question and divide by 81 to create your score. Please choose only one answer per question.

Point Scale:
0 = Never or almost never have the experience/effect. 1 = Mild experiences/effects
1 = Mild experiences/effects
2 = Moderate experiences/effects
3 = Severe/chronic experiences/effects

For all yes/no questions, 0 = no and 3 = yes


How to Interpret Results: Grand Total / 81

0-10% – Overall good blood sugar balance. Sound nutrition and healthy habits will maintain good balance.

11-20% – In need of a tune up to restore blood sugar balance before serious illness sets in. Diet and lifestyle improvements should shift to normal.

21-35% – Your blood sugar is out of balance and needs attention.

36-50% – Your blood sugar balance is very compromised and this is likely to significantly affect your state of health, well-being, and energy level.

51-100% – Your blood sugar balance is severely compromised and require immediate attention.

Insulin Resistance Symptom Questions

Insulin Resistance Assessment

Name(Required)
Crave sweets
Binge or uncontrolled eating
Excessive appetite
Crave coffee or sugar in the afternoon
Sleepy in afternoon
Fatigue that is relieved by eating
Fatigue after meals
Headache or shaky if meals are skipped or delayed
Irritable before meals
Family members with diabetes:
Increased thirst and appetite
Frequent urination
Slow starter in the morning
Eating sweets does not relieve cravings for sugar
Must have sweets after meals
Waist girth is equal to or larger than hip girth
Difficulty losing weight
Crave sweets during the day
Irritable if meals are missed
Depend on coffee to keep yourself going or to get started
Get lightheaded if meals are missed
Feel shaky, jittery, tremors
Agitated, easily upset, nervous
Poor memory, forgetful
Blurred vision
Difficult time losing weight despite exercising regularly
Difficult time losing weight despite exercising regularly

*With permission by Dr. Ritamarie Loscalzo