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BackTable / ENT / Tool
HOMA-IR Calculator
The HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) calculator is a widely used tool to estimate insulin resistance using fasting plasma glucose and insulin levels. Originally developed by Matthews et al. in 1985, the model assumes a feedback loop between hepatic glucose production and insulin secretion. The result provides a proxy for how effectively the body is responding to insulin.
Insulin resistance is a key pathophysiological feature of conditions like metabolic syndrome, type 2 diabetes, polycystic ovary syndrome (PCOS), and nonalcoholic fatty liver disease (NAFLD). Early detection of insulin resistance via an elevated HOMA-IR score can help guide lifestyle interventions and medical management before significant disease progression.. Though not diagnostic on its own, the HOMA-IR score is commonly used in both research and clinical practice to screen for insulin resistance.
HOMA-IR Calculator
Fasting Insulin (μU/mL)
Fasting Glucose (mg/dL)
Value
Value
HOMA-IR Scoring
Insulin and glucose values should be taken from a blood sample after a fast of 8–12 hours. Non-fasting values may lead to inaccurate results and should not be used for this calculation.
HOMA-IR Formula:
HOMA-IR = (Fasting Insulin [µU/mL] × Fasting Glucose [mg/dL]) ÷ 405
Interpretation of HOMA-IR Results
HOMA-IR scores reflect the estimated degree of insulin resistance:
• <1.0: Normal insulin resistance
• >1.9: Suggestive of early insulin resistanceWhile likely not overtly pathological, patients with HOMA-IR scores in this range may benefit from lifestyle changes like improved diet, physical activity, and weight management.
• >2.9: Reflects significant insulin resistance. This score may indicate underlying prediabetes, type 2 diabetes, or other metabolic dysfunction. Further diagnostic evaluation is often warranted.
It’s important to note that cutoff values can vary slightly depending on patient population, age, and lab standards. These ranges serve as general guidelines in the absence of population-specific reference intervals.
Clinical Applications of HOMA-IR
HOMA-IR is a practical tool in clinical endocrinology, primary care, and metabolic research. It is frequently used to:
• Assess risk for type 2 diabetes and cardiovascular disease
• Monitor insulin resistance in patients with obesity or PCOS
• Evaluate the effectiveness of insulin-sensitizing therapies
• Support decision-making around lifestyle interventions
Because it requires only fasting insulin and glucose values, it is easy to integrate into routine blood work without additional cost or burden on the patient.
Learn more on the BackTable ENT Podcast
BackTable is a knowledge resource for physicians by physicians. Get practical advice on the HOMA-IR Calculator and how to build your practice by listening to the BackTable Podcast.
References
[1] Matthews, D. R., Hosker, J. P., Rudenski, A. S., et al. "Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man." Diabetologia, 1985;28(7):412–419.
[2] Geloneze, B., Vasques, A. C. J., Stabe, C. F. C., et al. "HOMA1-IR and HOMA2-IR indexes in identifying insulin resistance and metabolic syndrome: Brazilian Metabolic Syndrome Study (BRAMS)." Arq Bras Endocrinol Metabol, 2009;53(2):281–287.
[3] Katz, A., Nambi, S. S., Mather, K., et al. "Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans." J Clin Endocrinol Metab, 2000;85(7):2402–2410.
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