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Educational guide

Insulin-resistance self-assessment checklist

A 20-point test that helps identify hidden signs of insulin resistance before lab testing.

Download PDF (in Estonian)

What is insulin resistance?

Insulin resistance is a state in which cells respond less to insulin. The pancreas compensates with higher insulin output, which keeps blood sugar normal for years — until the system overloads and pre-diabetes or type-2 diabetes appears.

This checklist helps you notice hidden signs. It is not a diagnostic test — a result above 7 points is a signal to take blood tests (HbA1c, fasting insulin, hsCRP).

Physical signs

  • Waist circumference > 88 cm (women) or > 102 cm (men)
  • Dark skin on the back of the neck, armpits or groin (acanthosis nigricans)
  • Skin tags on neck or armpits
  • Fat accumulates mainly around the abdomen, not the hips
  • Fatty liver on ultrasound
  • Acne or oily skin in adulthood
  • Losing weight is hard even with diet and training

Energy and eating patterns

  • Strong fatigue 1–2 hours after meals
  • Need to snack every 2–3 hours or you get "hangry"
  • Sugar cravings especially in the afternoon and evening
  • An afternoon nap feels unavoidable after lunch
  • Waking at night with hunger or palpitations
  • Hard to wake up; need coffee to function

Hormonal and other signs

  • Women: irregular periods or a PCOS diagnosis
  • Women: severe PMS or a hard menopause
  • Men: low libido or erectile difficulties
  • High blood pressure (> 130/85)
  • Triglycerides > 1.7 mmol/L or HDL < 1.0 mmol/L
  • Family history of type-2 diabetes or heart attack before 60
  • Sleep problems — onset, awakenings, sleep apnoea

Interpreting your score

Points markedInterpretationRecommendation
0–3Low riskMaintain lifestyle, check every 2 years
4–7Moderate riskBlood tests recommended within 6 months
8–12High riskBlood tests + consultation as soon as possible
13+Very high riskImmediate consultation: info@synage.ee

First steps when the score is high

  • Reduce added sugar and refined carbs — this alone can substantially improve insulin sensitivity in 4–8 weeks
  • Add strength training 2–3× per week — muscle is the main insulin-sensitive tissue
  • Walk 10–15 minutes after each meal — lowers the glucose peak by 30–50%
  • Sleep at least 7 hours — one bad night drops insulin sensitivity by 25%
  • Reduce meal frequency — 3 meals a day without snacking lets insulin fall

Educational material — does not replace individual medical consultation, diagnosis or treatment.

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