HOMA-IR: Insulin Resistance Index
HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) quantifies insulin resistance from a single fasting blood draw. Values above 2.0–2.5 suggest insulin resistance. Both glucose and insulin must be measured while fasting (≥8 hours).
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HOMA-IR Score
Formula: HOMA-IR = (Fasting Glucose mg/dL × Fasting Insulin µIU/mL) ÷ 405
Note: The 405 divisor is used when glucose is in mg/dL. If glucose is in mmol/L, use 22.5 instead.
Note: The 405 divisor is used when glucose is in mg/dL. If glucose is in mmol/L, use 22.5 instead.
HOMA-IR Reference Ranges
These thresholds are widely used clinically but vary slightly by population and lab methodology.
| HOMA-IR Value | Interpretation | Clinical Implication |
|---|---|---|
| < 1.0 | Optimal insulin sensitivity | Minimal insulin resistance |
| 1.0 – 1.9 | Normal range | Acceptable; monitor if risk factors present |
| 2.0 – 2.9 | Early insulin resistance | Lifestyle intervention indicated |
| 3.0 – 4.9 | Moderate insulin resistance | Pre-diabetes / metabolic syndrome likely |
| ≥ 5.0 | Significant insulin resistance | High risk; evaluate for T2DM, PCOS, NAFLD |
Associated conditions: Type 2 diabetes, pre-diabetes, polycystic ovary syndrome (PCOS), non-alcoholic fatty liver disease (NAFLD/MASH), metabolic syndrome, and cardiovascular disease risk.
Limitations: HOMA-IR is a research/screening tool. It is not a diagnostic test, and results vary by ethnicity, age, and assay. Insulin assays are not standardized across labs.
Limitations: HOMA-IR is a research/screening tool. It is not a diagnostic test, and results vary by ethnicity, age, and assay. Insulin assays are not standardized across labs.
In the Houston area?
Have questions about insulin resistance? See an endocrinologist.
Prediabetes, insulin resistance, PCOS and weight, at Endocrine & Diabetes Plus in Sugar Land and Memorial City. New patients are usually seen within 2 weeks; the earliest openings are with Dr. Chhavi Chadha. Telehealth follow-ups for patients anywhere in Texas.
Outside Texas? Share this result with your own doctor. This tool is for information only.
⚕️ Clinical note: HOMA-IR requires fasting conditions (≥8 hours). Insulin assays vary significantly between laboratories — use the same lab for serial measurements. HOMA-IR is a screening index, not a definitive diagnostic test. Clinical decisions should incorporate full metabolic panel, history, and clinical judgment. Based on the original HOMA model (Matthews DR et al., Diabetologia 1985;28:412–419).