The Metabolic Panel Cheat Sheet

The three numbers we read together

Fasting insulin describes the insulin present after a fast. Fasting glucose describes the glucose in the blood at that point. Looking at both helps us ask how the body is maintaining glucose, rather than treating the glucose result as the entire metabolic picture.

Triglycerides and HDL add another perspective. The triglyceride-to-HDL ratio is a calculation from the lipid panel that our framework uses as a metabolic clue. It does not directly measure insulin sensitivity or replace the wider assessment.

We use narrower practice ranges than many laboratory intervals to guide our review. Those ranges help us decide what deserves attention; they do not establish a diagnosis.

When comparing tests, record whether the sample was fasting and follow the preparation instructions supplied for the test. Use the same units and include medications, illness and meaningful routine changes. A trend is easier to interpret when its conditions are clear.

What the numbers are telling us

Insulin helps regulate the movement and storage of nutrients. In our coaching model, an elevated fasting-insulin pattern prompts a closer look at food intake, activity, body composition, sleep and recovery, even when glucose has not been flagged.

Glucose is influenced by food, liver glucose production, activity, stress, sleep and medication. A fasting result gives a specific snapshot. A1C adds a longer view but is also affected by the red blood cells on which it is measured.

Triglycerides carry energy through the circulation, while HDL participates in cholesterol transport. We use their relationship alongside the other findings. It should not be described as a direct particle-size test or a complete cardiovascular-risk assessment.

To calculate the conventional mg/dL ratio, divide triglycerides by HDL. If the report uses mmol/L, first multiply triglycerides by approximately 88.57 and HDL by 38.67. For example, triglycerides 1.35 mmol/L and HDL 1.55 mmol/L convert to approximately 120 and 60 mg/dL, giving a ratio of approximately 2.0. Dividing the unconverted values gives a different number.

Seven practical levers in the Wesnoski approach

Walk after meals. A manageable ten-minute walk is a practical starting point. Make it fit the person’s ability and routine.

Build a complete plate. Include a protein source and tolerated plant foods rather than relying on starch alone. Eating protein and vegetables first is one meal-structure option to try.

Train muscle consistently. Resistance training belongs in the plan because muscle uses glucose and supports physical capacity. The starting workload should match recovery, not overwhelm it.

Review liquid sugar. Look at sweet coffees, soft drinks and juice before making the rest of the diet unnecessarily restrictive. Choose one recurring drink to change first.

Review grazing. Understand whether constant snacking reflects habit, inadequate meals, training demands or medication needs. Build a meal rhythm that provides enough food rather than turning meal spacing into compulsory fasting.

Protect sleep. A sustainable sleep window and a repeatable evening routine are part of metabolic coaching, not extras added after the food plan.

Address body composition appropriately. Where fat loss is suitable, use a plan that preserves nourishment, muscle and recovery. Do not judge progress from scale weight alone.

These are tools to select and sequence. Starting all seven aggressively at once can make it difficult to identify what is helping or what is too much.

When the basics have not moved the pattern

MARCH starts by checking whether the person has enough energy and recovery capacity for the plan. We review the thyroid picture, iron and other relevant nutrients, gut symptoms, sleep, stress and hormonal context when the history points there.

We also check the implementation. Were meals substantial enough? Was training recoverable? Did a work schedule repeatedly interrupt sleep? Did a new medicine or illness coincide with the change? An apparent failure of the plan may be a mismatch between its demands and the person’s life.

We commonly review progress over eight to twelve weeks. The actual timing depends on the marker, the change and any clinical monitoring already underway. Compare the new result with the previous result and the routine that produced it.