HOMA-IR

HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) is a method used to estimate insulin resistance, which is a condition where the body’s cells become less responsive to the hormone insulin. Insulin resistance can lead to higher blood sugar levels and is associated with type 2 diabetes, obesity, and other metabolic disorders. Learn more about insulin here.

HOMA-IR is calculated using the fasting glucose and fasting insulin levels from a blood sample. The formula for HOMA-IR is:

$\text{HOMA-IR }=\left(\text{Fasting Insulin }(\mu IU/ml)\times \text{Fasting Glucose }(mg/dl)\right)/\; 405$

This calculation provides an index that reflects the function of beta cells (which produce insulin) and insulin sensitivity in the body. A higher HOMA-IR score indicates greater insulin resistance.

HOMA-IR is crucial for maintaining and assessing metabolic health because it offers a quantifiable measure of insulin resistance, a pivotal factor in numerous metabolic disorders, including type 2 diabetes and metabolic syndrome. By detecting insulin resistance early, HOMA-IR helps clinicians identify at-risk individuals before the manifestation of clinical symptoms, allowing for timely interventions. Additionally, HOMA-IR is valuable for monitoring the progression or remission of metabolic diseases in patients, providing insights into how effectively they are responding to treatment strategies like diet modifications, exercise, or pharmacological interventions. It also aids in tailoring these therapeutic strategies by highlighting the severity of insulin resistance, which can guide the aggressiveness of treatment approaches. Moreover, a high HOMA-IR score can indicate an increased risk of developing diabetes, enabling preventive measures to be put in place. Since insulin resistance is often linked with other conditions such as dyslipidemia, hypertension, and obesity, HOMA-IR also serves as a comprehensive tool for evaluating an individual’s overall metabolic health and pinpointing multiple risk factors simultaneously.

How can I better understand my HOMA-IR levels?

In general, a low HOMA-IR value is sought after because it is indicative of low fasting insulin and fasting glucose. While there is no consensus on “normal” HOMA-IR values yet, here are the generally accepted ranges:

•  <1.0 is considered insulin sensitive (low diabetes risk)
• 1.5-2.9 may be indicative of insulin resistance (borderline diabetes risk)
• 2.9< is considered significantly insulin resistant (high diabetes risk).

Ranges specific to the Cardiometabolic Program:

• Optimal: ≤1
• Good: 1.1-1.49
• Fair: 1.5-1.99
• Pay attention: ≥2

It is important to discuss your results with a physician if you are concerned with your HOMA-IR value to assess your metabolic health.

How can I maintain optimal HOMA-IR levels?

Since HOMA-IR is a calculation of fasting glucose and fasting insulin levels, some ways to improve these markers include:

Dietary Changes: Mediterranean diets, high-protein diets, and low-calorie diets are among a few interventions that have been shown to reduce HOMA-IR in various studies.

Lifestyle Changes: Whether it is HIIT, moderate-intensity, strength training, or resistance training, studies show that physical activity can significantly reduce HOMA-IR compared to sedentary individuals. Sufficient sleep duration (about 8 hours) lowers HOMA-IR levels.

Where can I learn more?

• Dr. Eric Berg DC (video) – HOMA-IR – The Best Insulin Resistance Test
• BMC Endocrine Disorders – Are HOMA-IR and HOMA-B good predictors for diabetes and pre-diabetes subtypes?
• The American Journal of Gastroenterology – Accuracy of HOMA-IR in Clinical Practice