For each question CIRCLE the number that best applies to your experience with that symptom over the past 3 months.
0 - Never or rarely – It is rare to experience this symptom.
1 - Occasionally – Once in awhile you may experience this – maybe once or twice a month.
2 - Often – You experience this 1-2 times a week, enough that it bothers you.
3 - Regularly – You are constantly aware of this as it occurs almost every day or weekly.
GROUP 2: Sugar Handling/Glucose
13. Anxious, nervous, or jittery when hungry
14. Tingling sensation in hands, fingertips, or lips
15. Shaky, jittery, hands tremble, especially when hungry
16. Hungry between meals
17. Irritable before meals
18. Light-headed if meals delayed
19. Abnormal craving for sweets or snacks
20. Agitation, easily upset, nervous
21. Confusion, difficulty thinking or concentrating
22. Mild, slight headaches
23. Pounding Headaches
24. Wake up suddenly at night feeling restless
25. Frequent urination during the day and night
26. Unusual thirst – feels like you can’t drink enough water
27. Extreme hunger – eating all the time
28. Vision blurs
29. Sores heal slowly
30. Loss of hair on your legs
31. Fatigue, relieved by eating
32. Heart palpitates if meals missed or delayed
Total Score for Group 2
