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28 Day Plan

IR Health Check

Check for signs of insulin resistance (IR) using your waist, height and blood pressure, and your blood test results.

Insulin resistance is at the root of poor metabolic health. It can be assessed for using five simple measures: waist-to-height ratio, blood pressure, glucose, triglycerides and HDL-cholesterol.

Add the measures you have below. Then press See my result.

Important: this IR Health Check does not provide a diagnosis, and it does not provide any clinical recommendations beyond repeating UK NICE guideline advice on when to seek medical attention. It does not replace advice from your doctor; read the disclaimer.

Units
About you
Sex

Used only for the HDL-cholesterol threshold. If you prefer not to say, the female threshold is used.

Has a doctor told you that you have type 2 diabetes?
Medicines you take (tick any that apply)

Taking one of these medicines counts as a sign of insulin resistance. A statin for cholesterol does not count here.

Waist and height
cm
cm

Measure your waist midway between the bottom of your ribs and the top of your hips. For most people this is just above the belly button. Breathe out naturally when taking the measurement. Keep the tape snug but not tight.

Blood pressure
mmHg
mmHg
Where was it taken?

Ideally, to take an accurate blood pressure reading sit and rest for five minutes first, with your arm supported at heart level. Take two readings a minute apart and use the second. For a proper home check, NICE suggests readings morning and evening for at least four days, leaving out the first day and taking the average. Stress, exertion and a full bladder all push it up.

Blood test results

These tests are commonly done at health checks. Your healthcare provider may be able to offer the tests, or you can use a home test kit. Leave blank anything you do not have.

Was the blood sample taken fasting (nothing but water for 8 hours or more)?

Glucose should only be tested fasted. Triglycerides are best measured fasted. HbA1c and HDL do not require fasting.

mmol/L

A finger-prick meter can read about 15% out, so a borderline meter result may be worth repeating on a lab test. It is important to be rested for the glucose test as stress, illness and exercise just before the test can increase the glucose level.

mmol/mol

HbA1c provides a measure of your average glucose over about three months. However, the result can be inaccurate if you have sickle cell or thalassaemia trait, anaemia, recent blood loss or a transfusion, or in later pregnancy. In all these cases use fasting glucose instead.

mmol/L

Triglycerides are fats in the blood. They are usually measured with a cholesterol (lipid) test. A fasting test is most accurate.

mmol/L

HDL-cholesterol is usually measured in a cholesterol test. It goes down with insulin resistance.

How the thresholds and ranges were chosen

'Good' means there is nothing to act on, though it doesn't necessarily mean the result is perfect. 'Watch' means it is worth some attention but it does not count towards the IR Health Check score. 'Alert' means the measure indicates insulin resistance and it counts towards the IR Health Check score. The 'See a clinician' note highlights the advice given by UK NICE guidelines about when to seek medical attention. These IR Health Check indicators are only discussed in relation to insulin resistance - very low readings can sometimes be an issue and you must seek medical attention if you have concerns.

MeasureGoodWatchAlertSee a clinicianSource

The IR Health Check score is how many of the five measures (waist-to-height ratio, blood pressure, glucose or HbA1c, triglycerides, HDL) are in the 'Alert' range. The TG/HDL ratio is shown for interest but not counted in the score.

Two cautions on the given thresholds. The waist-to-height ratio applies to everyone, but people from South Asian, Chinese, other Asian, Middle Eastern, Black African or Black Caribbean family backgrounds carry more risk at the same waist size, so a ratio near 0.5 may be more of a concern.1 And in Black African and Caribbean people, triglycerides and the TG/HDL ratio can stay normal despite insulin resistance.10

References

  1. National Institute for Health and Care Excellence. Overweight and obesity management. NICE guideline NG246. NICE; published 14 January 2025, last updated 20 January 2026. www.nice.org.uk/guidance/ng246
  2. National Institute for Health and Care Excellence. Hypertension in adults: diagnosis and management. NICE guideline NG136. NICE; published 28 August 2019, last updated 21 November 2023. www.nice.org.uk/guidance/ng136
  3. National Institute for Health and Care Excellence. Type 2 diabetes: prevention in people at high risk. NICE public health guideline PH38. NICE; published 12 July 2012, last updated 15 September 2017. www.nice.org.uk/guidance/ph38
  4. National Institute for Health and Care Excellence. Cardiovascular disease: risk assessment and reduction, including lipid modification. NICE guideline NG238. NICE; published 14 December 2023. www.nice.org.uk/guidance/ng238
  5. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640-1645. doi:10.1161/CIRCULATIONAHA.109.192644. PubMed.
  6. McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024;45(38):3912-4018. doi:10.1093/eurheartj/ehae178. PubMed.
  7. American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: Standards of Care in Diabetes 2026. Diabetes Care. 2026;49(Suppl 1):S27-S49. Full text on PMC.
  8. Selvin E, Steffes MW, Zhu H, Matsushita K, Wagenknecht L, Pankow J, et al. Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. N Engl J Med. 2010;362(9):800-811. doi:10.1056/NEJMoa0908359. PubMed.
  9. Zhang X, Gregg EW, Williamson DF, Barker LE, Thomas W, Bullard KM, et al. A1C level and future risk of diabetes: a systematic review. Diabetes Care. 2010;33(7):1665-1673. doi:10.2337/dc09-1939. PubMed.
  10. Sumner AE, Cowie CC. Ethnic differences in the ability of triglyceride levels to identify insulin resistance. Atherosclerosis. 2008;196(2):696-703. doi:10.1016/j.atherosclerosis.2006.12.018. PubMed.
  11. World Health Organization. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus: abbreviated report of a WHO consultation. Geneva: WHO; 2011. www.who.int
  12. Miller M, Stone NJ, Ballantyne C, Bittner V, Criqui MH, Ginsberg HN, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2011;123(20):2292-2333. doi:10.1161/CIR.0b013e3182160726. PubMed.
  13. McLaughlin T, Abbasi F, Cheal K, Chu J, Lamendola C, Reaven G. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med. 2003;139(10):802-809. doi:10.7326/0003-4819-139-10-200311180-00007. PubMed.
  14. Nordestgaard BG, Langsted A, Mora S, Kolovou G, Baum H, Bruckert E, et al. Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut-points. A joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. Eur Heart J. 2016;37(25):1944-1958. doi:10.1093/eurheartj/ehw152. PubMed.
  15. National Cholesterol Education Program. Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): executive summary. NIH publication 01-3670. Bethesda: National Heart, Lung, and Blood Institute; 2001. www.nhlbi.nih.gov
  16. Pleus S, Baumstark A, Jendrike N, Mende J, Link M, Zschornack E, et al. System accuracy evaluation of 18 CE-marked current-generation blood glucose monitoring systems based on EN ISO 15197:2015. Diabetes Ther. 2024;15(2):447-459. doi:10.1007/s13300-023-01520-4. PubMed.

Each reference was opened and checked against the threshold it supports on 3 November 2026. Guidelines change: the links go to the current version.

This IR Health Check form looks for signs of insulin resistance. It is not a diagnosis and does not replace a test from your doctor. If you take medication for diabetes or blood pressure, speak to your healthcare professional before changing how you eat. Read the full disclaimer.

A paper version of the IR Health Check is available on the Learn page.

The 28 Day Plan is designed to improve insulin resistance and the IR Health Check measures should track with improvement.

Delete your saved checks?

This permanently deletes them from this device. It can’t be undone.