Preparation Info for Tactical Audit ref:040

• Pre-Tactical-Audits Questions

  You will be assigned one of the following Assessments. The questions must be completed PRIOR to your Tactical Audit Consultation with JJ.

• v.1

  version 1.0 – can be ran on any browser (just open the html file (full html below)

  🔬 Armstrong Metabolic Reversal Assessment

  Practitioner-Administered Tool | 45-Minute Consultation | Version 1.0

  © J.J. Armstrong, M.Sc. | Proprietary & Confidential

  1. Demographics

  2. Anthropometrics

  3. T2D Diagnosis

  4. Medications

  5. Complications

  6. Lifestyle

  7. Psychology

  8. Knowledge

  9. Logistics

  10. Financial

  11. Movement

  12. Family History

  Section 1: Demographics & Baseline

  1.1 Full Name

  1.2 Date of Birth

  📊 Age Reference: Under 50 = favorable | 50-65 = typical | Over 65 = requires modified approach

  1.3 Country & Time Zone

  1.4 Referring Physician

  Next →

  Section 2: Body Composition

  2.1 Weight (e.g., 85 kg or 187 lbs)

  📊 BMI Reference: 18.5-24.9 = Normal | 25-29.9 = Overweight | 30+ = Obesity | >40 = Severe Obesity

  2.2 Height (e.g., 175 cm or 5’9″)

  2.3 Waist Circumference

  ⚠️ Risk Thresholds: Male >102 cm (40 in) | Female >88 cm (35 in) = High visceral fat

  2.4 Years since highest weight (or current if highest)

  ← BackNext →

  Section 3: T2D History

  3.1 Date of Diagnosis (Month/Year)

  ⏱️ 10-Year Window: <5 years = optimal reversal | 5-10 years = possible | >10 years = challenging

  3.2 Most Recent A1c (%)

  📈 A1c Scale: <6.5% = Excellent | 6.5-7.4% = Good | 7.5-8.4% = Moderate | 8.5-9.4% = High Risk | >9.5% = Critical

  3.3 Average Fasting Morning Glucose (mg/dL)

  Target: 80-130 mg/dL | >160 = poor control

  3.4 Glucose Measurement Method CGMFingerstickBothNone

  ← BackNext →

  Section 4: Medication Profile

  4.1 Current Diabetes Medications (list all)

  💊 Insulin = Major Barrier | Sulfonylureas = Hypoglycemia Risk | GLP-1/SGLT2 = Supportive

  4.2 Daily Insulin Units (if none, write 0)

  ← BackNext →

  Section 5: Complications & Comorbidities

  5.1 Neuropathy (tingling/pain in feet)?NoMildModerateSevere

  5.2 Retinopathy (eye disease)?NoYes – stableYes – active

  5.3 Kidney Function (eGFR if known)

  5.4 Heart Disease / Heart Failure?NoYes – stableYes – recent event

  🚩 Red Flags: eGFR <45, active retinopathy, heart failure = physician clearance mandatory

  ← BackNext →

  Section 6: Lifestyle & Behaviors

  6.1 Exercise sessions per week (avg)

  6.2 Average sleep (hours/night)

  6.3 Perceived stress (1-10, 10=highest)

  6.4 Current diet patternStandard AmericanLow CarbKetoMediterraneanIntermittent FastingNo Plan

  📊 Ideal Targets: Exercise 4+ days/wk | Sleep 7-8 hrs | Stress <5/10

  ← BackNext →

  Section 7: Psychology & Readiness

  7.1 Commitment to reversal (1-10, 10=fully committed)

  7.2 Do you believe T2D can be reversed?YesUnsureNo

  7.3 What are you NOT willing to change?

  7.4 Previous weight loss improved blood sugar?YesNoNever tried

  🎯 Key Predictor: Previous weight loss improving glucose = strongest success indicator

  ← BackNext →

  Section 8: Diabetes Knowledge

  8.1 Rate your T2D understanding (1-10)

  8.2 Heard of Dr. Roy Taylor?YesNo

  ← BackNext →

  Section 9: Practical Logistics

  9.1 Hours per week you can dedicate to program

  9.2 Family support level (1-10)

  ← BackNext →

  Section 10: Financial Commitment

  10.1 Willing investment to become T2D-free ($)

  10.2 Is cost a barrier?NoYesUnsure

  ← BackNext →

  Section 11: Physical Capability

  11.1 Can you get up from chair without arms?YesWith difficultyNo

  11.2 Any joint pain limiting exercise?

  ← BackNext →

  Section 12: Family History

  12.1 Parents or siblings with T2D?NoYes – oneYes – multiple

  ← BackComplete Assessment →

  📋 Assessment Results

  Start New Assessment
• v.2
  Accordion content

  🔬 Armstrong Metabolic Reversal Assessment

  Adaptive Clinical Tool | Enhanced v2.0 | PDF/CSV/Email

  © J.J. Armstrong, M.Sc. | Proprietary & Confidential

  🎨 Theme:

  ☀️ Light 🌙 Dark 🔴 Red/Dark Blue

  💾 Save JSON 📂 Load JSON 🔄 Reset 📊 Export CSV 📑 Export PDF 🖨️ Print Report

  Section 1 of 10 Score: — Complete: 0%

  ⚠️ Please complete all required fields before submitting

  Section 1: Demographics & Baseline

  Basic information to establish client identity and context.

  1.1 Full Name *

  1.2 Date of Birth

  📊 Age Reference: Under 50 = favorable | 50-65 = typical | Over 65 = modified approach

  1.3 Email (for report) *

  1.4 Referring Physician

  Next →

  Section 2: Body Composition

  2.1 Weight (e.g., 85 kg or 187 lbs)

  2.2 Height (e.g., 175 cm or 5’9″)

  2.3 Waist Circumference

  ⚠️ Risk: Male >102cm | Female >88cm = high visceral fat

  ← BackNext →

  Section 3: T2D History & Severity

  3.1 Date of Diagnosis (Month/Year) *

  ⏱️ <5 years = optimal reversal | 5-10 years = possible | >10 years = challenging

  3.2 Most Recent A1c (%) *

  📈 <6.5% Excellent | 6.5-7.4% Good | 7.5-8.4% Moderate | 8.5-9.4% High Risk | >9.5% Critical

  3.3 Average Fasting Morning Glucose (mg/dL)

  3.4 Are you currently taking INSULIN?

  Yes No

  3.4.1 Daily Insulin Units

  3.4.2 Type of InsulinBasal only (long-acting)Basal + Bolus (mealtime)Premixed

  3.5 Are you taking Sulfonylureas (glipizide, glyburide)?

  Yes No

  ⚠️ Hypoglycemia risk during intervention – physician coordination required

  ← BackNext →

  Section 4: Complications & Comorbidities

  4.1 Do you have neuropathy?

  Yes No

  4.1.1 Severity (1-10 scale)

  4.2 Any history of heart disease or heart failure?

  Yes No

  🚩 Physician clearance mandatory before exercise program

  4.3 eGFR (kidney function) if known

  🚩 eGFR <45 = physician clearance required

  ← BackNext →

  Section 5: Lifestyle & Behaviors

  5.1 Exercise sessions per week

  5.2 Average sleep (hours/night)

  5.3 Perceived stress (1-10)

  5.4 Current diet patternStandard AmericanLow CarbKetoMediterraneanIntermittent FastingNo Plan

  ← BackNext →

  Section 6: Psychology & Reversal Readiness

  6.1 Commitment to reversal (1-10) *

  6.2 Do you believe T2D can be reversed? *

  Yes Unsure No

  6.3 Has previous weight loss improved your blood sugar?

  Yes (Strong predictor) No Never tried

  6.4 What are you NOT willing to change?

  ← BackNext →

  Section 7: Family & Social Support

  7.1 Family support level (1-10)

  7.2 Parents or siblings with T2D?NoYes – oneYes – multiple

  7.3 Living situationAloneWith spouse/partnerWith familyWith roommates

  ← BackNext →

  Section 8: Practical Logistics

  8.1 Hours per week you can dedicate

  8.2 Desired accountability level (1-5)

  8.3 Ever done intermittent fasting?

  Yes No

  8.3.1 Longest fast completed (hours)

  ← BackNext →

  Section 9: Financial Commitment

  9.1 Willing investment to become T2D-free ($)

  9.2 Is cost a barrier?NoYesUnsure

  ← BackNext →

  Section 10: Physical Capability

  10.1 Can you get up from chair without using arms?YesWith difficultyNo

  10.2 Any joint pain limiting exercise?

  ← BackComplete Assessment →

  📋 Assessment Results

  📝 Consultant Notes (for internal record)

  📄 Download HTML Report ✉️ Email Client Report 🔄 New Assessment
• v,3

  v.3

  🔬 Armstrong Metabolic Reversal

  Adaptive assessment · conditional logic · clinical decision support

  © J.J. Armstrong, M.Sc. | v3.0

  💾 Save JSON 📂 Load ⟳ Reset

  📄 Export Report ✉️ Copy email report

  1. Demo 2. Body 3. T2D / Meds 4. Complications 5. Lifestyle 6. Psychology 7. Support 8. Logistics 9. Financial 10. Movement 📊 Results

  Section 1 of 10Score: —

  1. Demographics & baseline

  Full name

  Date of birth

  📊 Age reference: under 50 favorable

  Email (for report)

  Referring physician

  Next →

  2. Body composition

  Weight (e.g., 85 kg / 187 lbs)

  Height

  Waist circumference

  ⚠️ Male >102cm / female >88cm = high visceral fat

  ← BackNext →

  3. T2D history & medications

  Diagnosis date (MM/YYYY)

  Most recent A1c (%)

  <6.5% excellent | 6.5-7.4% good | 7.5-8.4% moderate | >9.5% critical

  Fasting morning glucose (mg/dL)

  Are you taking INSULIN?

  Yes No

  Daily insulin units

  Sulfonylureas (glipizide/glyburide)?

  Yes No

  ⚠️ Hypoglycemia risk – coordinate with physician

  ← BackNext →

  4. Complications & comorbidities

  Neuropathy (tingling/pain in feet)?

  Yes No

  Severity (1-10)

  Heart disease / heart failure?

  Yes No

  🚩 Physician clearance mandatory before exercise

  eGFR (kidney function)

  ← BackNext →

  5. Lifestyle & behaviors

  Exercise sessions/week

  Sleep (hours/night)

  Perceived stress (1-10)

  Current diet patternStandard AmericanLow CarbKetoMediterraneanIntermittent FastingNo Plan

  ← BackNext →

  6. Psychology & readiness

  Commitment to reversal (1-10)

  Do you believe T2D can be reversed?

  Yes Unsure No

  Previous weight loss improved blood sugar?

  Yes (strong predictor) No Never tried

  What are you NOT willing to change?

  ← BackNext →

  7. Family & social support

  Family support level (1-10)

  Parents/siblings with T2D?NoYes – oneYes – multiple

  Living situationAloneWith spouse/partnerWith family

  ← BackNext →

  8. Practical logistics

  Hours/week you can dedicate

  Desired accountability (1-5)

  Ever done intermittent fasting?

  Yes No

  Longest fast (hours)

  ← BackNext →

  9. Financial commitment

  Willing investment ($)

  Is cost a barrier?NoYesUnsure

  ← BackNext →

  10. Physical capability

  Get up from chair without arms?YesWith difficultyNo

  Joint pain limiting exercise?

  ← BackComplete →

  📝 Consultant notes (internal)

  📋 Copy email to clipboard

  📄 Download full report⟳ New assessment
• CHARTS
  Accordion content

  📊 Armstrong Metabolic Reference Charts

  Clinical decision support | Evidence-based thresholds | v1.0

  © J.J. Armstrong, M.Sc. | Proprietary & Confidential

  📑 Table of Contents

  1. A1c Clinical Classification 2. Fasting Glucose Reference 3. Time in Range (CGM) Standards 4. Years Since Diagnosis – Reversal Window 5. BMI Classification 6. Waist Circumference Risk Thresholds 7. Body Fat Percentage Norms 8. Waist-to-Hip Ratio Standards 9. Medication Reversal Compatibility 10. Insulin Dose – Difficulty Scale 11. Blood Pressure Classification 12. Lipid Profile Targets 13. eGFR Kidney Function Stages 14. Neuropathy Severity Scale 15. Exercise Prescription Zones 16. Sleep Duration & Metabolic Health 17. Perceived Stress Scale (PSS-4) 18. Depression Screening (PHQ-2) 19. Commitment to Change Scale 20. Self-Efficacy for Diabetes 21. Epworth Sleepiness Scale 22. STOP-Bang Sleep Apnea Screen 23. Physical Activity Readiness 24. Functional Movement Screener 25. Family History Risk Loading 26. Social Support Scale 27. Health Literacy Assessment 28. Financial Readiness Index 29. Program Suitability Composite Score 30. Reversal Probability Estimator

  Chart 1: A1c Clinical Classification

  ↑ Back to TOC

  A1c (%)	Classification	Reversal Potential
  <5.7	Normal	N/A
  5.7 – 6.4	Prediabetes	Excellent
  6.5 – 7.0	Diabetes – Controlled	Very High
  7.1 – 7.5	Diabetes – Moderate	High
  7.6 – 8.5	Diabetes – Poor Control	Moderate
  8.6 – 9.5	Diabetes – Very Poor	Low
  >9.5	Diabetes – Critical	Very Low

  📖 Source: American Diabetes Association. “Standards of Care in Diabetes—2025.” Diabetes Care 2025;48(Suppl. 1):S27-S49. https://doi.org/10.2337/dc25-S002

  Chart 2: Fasting Glucose Reference

  ↑ Back to TOC

  mg/dL	mmol/L	Classification
  70-99	3.9-5.5	Normal
  100-125	5.6-6.9	Impaired Fasting Glucose
  126-160	7.0-8.9	Diabetes – Fair Control
  161-200	9.0-11.1	Diabetes – Poor Control
  >200	>11.1	Diabetes – Critical

  📖 Source: World Health Organization (WHO) diagnostic criteria. WHO Reference

  Chart 3: Time in Range (CGM) Standards

  ↑ Back to TOC

  Time in Range 70-180 mg/dL	Classification
  >85%	Excellent
  70-85%	Good
  50-70%	Fair
  <50%	Poor

  📖 Source: Battelino T, et al. ATTD consensus. Diabetology International 2025. Link

  Chart 4: Years Since Diagnosis – Reversal Window

  ↑ Back to TOC

  Years	Reversal Probability	Beta Cell Function
  <2	85-95%	Near normal
  2-5	70-85%	Mild reduction
  5-7	50-70%	Moderate reduction
  7-10	30-50%	Significant reduction
  10-15	15-30%	Severe reduction
  >15	<15%	Minimal remaining

  📖 Source: DiRECT trial (Taylor et al., Lancet 2018) & 5-year extension. Diabetes UK

  Chart 5: BMI Classification

  ↑ Back to TOC

  BMI Range	Classification
  <18.5	Underweight
  18.5-24.9	Normal
  25-29.9	Overweight
  30-34.9	Obesity Class I
  35-39.9	Obesity Class II
  ≥40	Obesity Class III

  📖 Source: World Health Organization (WHO) BMI classification. WHO BMI

  Chart 6: Waist Circumference Risk Thresholds

  ↑ Back to TOC

  Gender	Low Risk	High Risk
  Male	<94 cm (<37 in)	≥102 cm (≥40 in)
  Female	<80 cm (<31.5 in)	≥88 cm (≥35 in)

  📖 Source: IDF/WHO/NIH. PMC 7231748

  Chart 7: Body Fat Percentage Norms

  ↑ Back to TOC

  Category	Male	Female
  Essential Fat	2-5%	10-13%
  Athletes	6-13%	14-20%
  Fitness	14-17%	21-24%
  Average	18-24%	25-31%
  Obese	>25%	>32%

  📖 Source: ACSM/ACE via InBody USA (clinical consensus)

  Chart 8: Waist-to-Hip Ratio Standards

  ↑ Back to TOC

  Risk	Male	Female
  Low Risk	<0.85	<0.75
  Moderate	0.85-0.95	0.75-0.85
  High	0.96-1.00	0.86-0.90
  Very High	>1.00	>0.90

  📖 Source: World Health Organization (WHO) expanded

  Chart 9: Medication Reversal Compatibility

  ↑ Back to TOC

  Medication	Compatibility
  Metformin	✓ Fully compatible
  SGLT2 / GLP-1	✓ Compatible
  Sulfonylureas	⚠️ High caution (hypoglycemia)
  Insulin <20u	⚠️ Caution
  Insulin >50u	⚠️ Major barrier

  📖 Based on ADA/EASD consensus & Armstrong Protocol clinical experience

  Chart 10: Insulin Dose – Difficulty Scale

  ↑ Back to TOC

  Units/day	Difficulty
  0	Low
  1-10	Low-Moderate
  11-20	Moderate
  21-35	High
  36-50	Very High
  >50	Severe

  📖 Armstrong Protocol clinical algorithm

  Chart 11: Blood Pressure Classification

  ↑ Back to TOC

  Category	Systolic	Diastolic
  Normal	<120	<80
  Elevated	120-129	<80
  Stage 1 HTN	130-139	80-89
  Stage 2 HTN	≥140	≥90

  📖 Source: ACC/AHA 2025 Guidelines. Link

  Chart 12: Lipid Profile Targets

  ↑ Back to TOC

  Lipid	Optimal (mg/dL)
  LDL	<100
  HDL (M)	>40
  HDL (F)	>50
  Triglycerides	<150

  📖 ADA/EASD consensus

  Chart 13: eGFR Kidney Function Stages

  ↑ Back to TOC

  eGFR	Stage
  >90	Normal
  60-89	Mild
  45-59	Mild-Mod
  30-44	Moderate
  15-29	Severe
  <15	Kidney Failure

  📖 KDIGO 2024 CKD Guideline

  Chart 14: Neuropathy Severity Scale

  ↑ Back to TOC

  Severity	Symptoms
  None (0)	No symptoms
  Mild (1-3)	Occasional tingling
  Moderate (4-6)	Regular numbness, mild pain
  Severe (7-10)	Constant pain, loss of sensation

  📖 Clinical consensus – Armstrong Protocol

  Chart 15: Exercise Prescription Zones

  ↑ Back to TOC

  Zone	%HRmax	T2D Benefit
  Fat Oxidation	60-70%	Insulin sensitivity +++
  HIIT	>88%	Glucose disposal ++++

  📖 ACSM guidelines + Armstrong Protocol

  Chart 16: Sleep Duration & Metabolic Health

  ↑ Back to TOC

  Sleep	Impact
  <5 hrs	Severe negative (↓ insulin sensitivity 30-40%)
  5-6 hrs	Moderate negative
  7-8 hrs	Optimal

  📖 Cappuccio et al. (2010) & clinical consensus

  Chart 17: Perceived Stress Scale (PSS-4)

  ↑ Back to TOC

  Score	Stress Level
  0-4	Low
  5-7	Moderate
  8-12	High

  📖 Cohen S. (1983) – Perceived Stress Scale

  Chart 18: Depression Screening (PHQ-2)

  ↑ Back to TOC

  Score	Action
  0-1	Normal
  2-3	Monitor
  4-6	Refer for support

  📖 Kroenke K (2003) – PHQ-2

  Chart 19: Commitment to Change Scale

  ↑ Back to TOC

  Score	Recommendation
  1-3	Do NOT enroll
  4-6	Motivational interviewing needed
  7-8	Acceptable with support
  9-10	Ideal candidate

  📖 Armstrong Protocol proprietary scale

  Chart 20: Self-Efficacy for Diabetes

  ↑ Back to TOC

  Score (5-50)	Level
  40-50	High – excellent candidate
  25-39	Moderate – needs accountability
  <25	Low – preparatory phase required

  📖 Armstrong Protocol proprietary

  Chart 21: Epworth Sleepiness Scale

  ↑ Back to TOC

  Score	Meaning
  0-7	Normal
  8-9	Average
  10-12	Sleepy
  13-16	Very sleepy
  17-24	Dangerous – refer for sleep study

  📖 Johns MW (1991) – Epworth Sleepiness Scale

  Chart 22: STOP-Bang Sleep Apnea Screen

  ↑ Back to TOC

  Score	Risk
  0-2	Low
  3-4	Intermediate – consider sleep study
  5-8	High – sleep study recommended

  📖 Chung F (2008) – STOP-Bang questionnaire

  Chart 23: Physical Activity Readiness

  ↑ Back to TOC

  Days/week	Reversal Impact
  0	Severe negative
  1-2	Moderate negative
  3-4	Positive
  5-6	Strongly positive
  7	Excellent

  📖 ACSM / Armstrong Protocol consensus

  Chart 24: Functional Movement Screener

  ↑ Back to TOC

  Passes	Program
  5/5	Full exercise prescription
  3-4	Modified program
  1-2	Supervised only
  0	PT referral recommended

  📖 Cook G (2006) – Functional Movement Screen

  Chart 25: Family History Risk Loading

  ↑ Back to TOC

  ；

  Family History	Genetic Loading
  No relatives	Low
  1 parent, age >60	Low-Moderate
  1 parent, age <50	Moderate
  2 parents	High
  Parent + sibling	Very High

  📖 Clinical consensus – DiRECT predictors

  Chart 26: Social Support Scale

  ↑ Back to TOC

  📖 Armstrong Protocol proprietary

  Chart 27: Health Literacy Assessment

  ↑ Back to TOC

  Score (5-50)	Prognosis
  40-50	Strong – excellent prognosis
  25-39	Adequate
  <25	Insufficient – program support needed

  Score (5-15)	Literacy Level
  12-15	High – use technical language
  8-11	Moderate – plain language
  5-7	Low – extensive education
  <5	Very low – refer to basic education

  📖 Armstrong Protocol proprietary scale

  Chart 28: Financial Readiness Index

  ↑ Back to TOC

  Score (5-15)	Alignment
  13-15	Strong – full alignment
  9-12	Moderate – may need payment plan
  5-8	Poor – not suitable for premium program

  📖 Armstrong Protocol proprietary

  Chart 29: Program Suitability Composite Score

  ↑ Back to TOC

  Score (6-24)	Category
  21-24	IDEAL – fast-track enrollment
  17-20	GOOD – proceed with confidence
  13-16	BORDERLINE – extended prep phase
  <13	NOT SUITABLE – redirect

  📖 Armstrong Protocol proprietary composite

  Chart 30: Reversal Probability Estimator

  ↑ Back to TOC

  Positive Factors (of 6)	Probability
  6/6	90-95%
  5/6	75-85%
  4/6	60-70%
  3/6	40-55%
  2/6	25-35%
  1/6	10-20%
  0/6	<5%

  📖 Based on DiRECT trial predictors (Taylor et al., 2018)

  © J.J. Armstrong, M.Sc. | Armstrong Metabolic Institute | All Rights Reserved

  These reference charts are proprietary clinical tools. Not for distribution without license.