Find out if diabetes is coming. Then stop it.
Your annual physical checks blood sugar after the damage is done. We test the early warning signs your doctor doesn't check, put a glucose monitor on your arm for 14 days, and build a plan to address what we find. Then we retest to see whether it worked.
How this protocol works
This isn't just testing. It's a coached cycle designed to get you where you want to be.
What we measure
OGTT with insulin
The most revealing metabolic test
Glucose and insulin measured at 5 points over 2 hours. Shows how much insulin your body has to pump out to clear a glucose load. Many people with normal fasting labs are already over-secreting insulin postprandially. We also run HbA1c and TG/HDL ratio for the full picture.
Fasting insulin
The earliest warning sign
This number rises years before blood sugar does. Most doctors never order it. By the time A1c is high, your body has been struggling with insulin for years.
14-day glucose monitor
Your body, in real time
A small sensor on your arm tracks how you respond to every meal, workout, and night of sleep. No two people respond the same way.
HOMA-IR
Your insulin resistance score
Tells us how hard your body is working to keep blood sugar normal. A fasting calculation that gives your clinical team a quick baseline to tier your risk and track progress.
Liver panel
Where insulin resistance hides first
ALT, AST, and GGT flag metabolic stress in the liver before it shows up in blood sugar. An ALT your doctor calls 'normal' may already be elevated.
Uric acid
A metabolic stress signal
Rising uric acid tracks with insulin resistance and liver fat. It's both a marker and a driver of the problem, and most physicals don't flag it until gout shows up.
What’s different after this protocol
You know whether your body is heading toward diabetes, years before a standard blood test would catch it.
If it is, you’ve already started reversing it. Not monitoring it. Not “keeping an eye on it.” Your results are moving because your team built a plan and worked it with you.
We retest at the end. You see the before and after. If the results moved, you know the plan is working. If they didn’t, we adjust and keep going until they do.
What this protocol delivers
- Your fasting insulin and HOMA-IR scores, the numbers your annual physical doesn’t check
- 14 days of continuous glucose data, so you see how your body responds to food, exercise, sleep, and stress
- A metabolic risk tier (A, B, or C) with specific targets for each marker
- Paired experiments that show which changes actually move your glucose
- A dietary plan built by a registered dietitian from your CGM data, not a generic handout
- A clear next step if lifestyle changes aren’t enough (medication evaluation, additional protocols)
- Follow-up labs that show whether the plan worked
The test your doctor runs catches diabetes after it arrives
Most annual physicals check something called A1c, which is a 3-month average of your blood sugar. If it comes back normal, you’re told you’re fine.
By the time A1c goes up, your body has been struggling with insulin for years. There’s an earlier signal, fasting insulin, that shows the problem building long before blood sugar moves. Most doctors never order it.
A1c is the smoke alarm going off. Fasting insulin is the smell of something burning three rooms away. We go looking for the smell.
More than a third of American adults are on the path to diabetes. Only 19% have been told. The rest heard “looks good” at their last physical and went home.
We don’t hand you a report and wish you luck
Your team places the glucose monitor, draws the blood your doctor skips, runs experiments with you for 14 days, and retests to confirm the plan worked. Your dietitian and physician are in the picture the whole way.
See the full process
Your team places the glucose monitor and walks you through setup. Blood is drawn for the tests your doctor skips: fasting insulin, HOMA-IR, and liver markers that flag metabolic stress early. You eat your normal diet for 14 days while your team checks in and flags early patterns.
Once results are in, your dietitian walks you through the full picture: HOMA-IR, fasting insulin, CGM summary, and your risk tier. From there you start running experiments on yourself. Walk after dinner, see if your glucose spike drops. Eat protein before the pasta. Skip the morning coffee for a few days and watch what happens to your fasting results. The answers show up on your arm.
From there, your dietitian and team work with you on implementation. Specific diet changes designed around how your body responds to food. An exercise approach that’s particularly good at lowering blood sugar. If the results call for medication, your physician evaluates from day one.
Then we retest. Same blood draw. Same markers. Your full team reviews the results against your tier targets. The results either moved or they didn’t.
We match the plan to the severity
After your labs come back, we assign a tier. Think of it like triage.
Tier A: your metabolism is healthy. You’re here to confirm that and see how your body responds to food in real time.
Tier B: early signs of insulin resistance. The stage where diet and exercise changes make the biggest difference, before medication enters the picture.
Tier C: your body needs more help. Insulin resistance is significant. Medication is on the table from day one, alongside lifestyle changes.
See what each tier includes
Tier A. Your baseline results look good. Most people at this level are surprised by what the glucose monitor shows, even when the blood work came back clean. The 14 days of data tell you how your body actually handles food, sleep, and exercise, so you know what to keep doing.
Tier B. Your body is working harder than it should to keep blood sugar in range. A dietitian builds your plan from your glucose data. Your team works it with you. Retest at the end shows whether the plan moved the right markers.
Tier C. We don’t ask you to tough it out on diet alone for half a year and see what happens. Your doctor evaluates medication from day one, alongside the lifestyle changes. You get more clinical touchpoints and a longer runway.
Common questions
Is this protocol right for me?
A few patterns fit. Your doctor says your blood sugar is fine, but your dad got Type 2 at 55 and you'd rather not find out the same way he did. You got flagged as prediabetic and told to watch what you eat, and that was the whole plan. You've been eating well and exercising and something still feels off: energy comes and goes, weight won't move, nobody has a good answer for why. Or you've worn a glucose monitor on your own and didn't know what to do with the numbers.
Do I need to do other protocols first?
No. Most people whose initial blood work flags something metabolic start here. It's also a good starting point if diabetes runs in your family and you want to get ahead of it.
I've worn a glucose monitor before. What's different?
The device is the same. Everything around it is different. We design experiments specific to your data, a dietitian reads your glucose traces next to your blood work, and the whole picture feeds into a plan your team works with you for weeks. A glucose monitor alone is a screen with squiggly lines. This puts a clinical team behind those lines.
What if my blood sugar is normal?
Good. That means you're early. Blood sugar is the last thing to go wrong, not the first. We test the markers that show problems years before a standard physical catches them. If everything comes back clean, you know for sure. And you still get 14 days of data showing how your body handles food, which is useful regardless.
How does this work?
The glucose monitor sits on your arm for 14 days. Your care team works through the plan with you and retests to confirm the results moved.
What comes after this protocol?
Your data feeds into other protocols. Glucose doesn't sit by itself. Members who find their spikes track with bad sleep often move into Sleep Health next. The glucose data feeds into exercise programming in Physical Capacity. If your liver markers or cholesterol ratios came back elevated, that changes the conversation in Cardiovascular Risk. Your team recommends based on your actual results.
What does this cost?
Included in Protocol membership: $695/mo, or $7,500/yr prepaid (save $840). The Foundation Assessment is the on-ramp: $1,500 standalone, included with annual membership.
From the Protocol blog
Blood sugar is the last thing to go wrong. Not the first.
If diabetes is in your future, we find it early. We build a plan, work it with you, and retest to see whether it's working.
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