HOMA-IR
Measure of insulin resistance from fasting values
Also known as
Definition
HOMA-IR is a calculated index derived from fasting glucose and fasting insulin that assesses cellular insulin sensitivity. It is an early indicator of type 2 diabetes and metabolic syndrome, detectable before classical diabetes markers become abnormal. Formula: (fasting glucose [mmol/l] × fasting insulin [mU/l]) ÷ 22.5.
| Parameter | Value |
|---|---|
| Unit | Index (dimensionless) |
| Reference Range | < 2.5 (per clinical guidelines) |
| Optimal Range (lab2go) | < 1.5 (metabolically healthy) |
↓ What a low value means
HOMA-IR < 1.0 indicates high insulin sensitivity — metabolically optimal and typical for physically active individuals with balanced nutrition. Very low values (< 0.5) are clinically unremarkable. HOMA-IR can appear falsely low in type 1 diabetes or insulin deficiency (e.g., late LADA), since fasting insulin is very low in those cases.
↑ What a high value means
HOMA-IR 2.5–5.0: insulin resistance, elevated risk of metabolic syndrome, type 2 diabetes, NAFLD, hypertension, PCOS. HOMA-IR > 5.0: pronounced insulin resistance, often with obesity, type 2 diabetes, or steroid therapy. Insulin resistance is also associated with elevated triglycerides, low HDL, and elevated hsCRP.
✓ How to optimize this marker
Diet: carbohydrate reduction, low-carb or Mediterranean diet, intermittent fasting (16:8 or 5:2 demonstrably lowers HOMA-IR). Exercise: aerobic and strength training increase GLUT4 expression and lower HOMA-IR. Weight loss: 5–10% body weight reduction measurably reduces insulin resistance. Optimize sleep (> 7 hours). Reduce stress (cortisol inhibits insulin action).
When to test
Mandatory fasting (at least 8–12 hours, water only). Fasting insulin and fasting glucose are drawn simultaneously and HOMA-IR calculated from these values. Screening with overweight, prediabetes, PCOS, fatty liver, metabolic syndrome. Follow-up every 3–6 months with active interventions.
Frequently asked questions
How do I calculate HOMA-IR myself? +
HOMA-IR = (fasting glucose [mmol/l] × fasting insulin [mU/l]) ÷ 22.5. With glucose in mg/dl: first divide by 18 for mmol/l. Example: 5.0 mmol/l glucose × 10 mU/l insulin ÷ 22.5 = HOMA-IR 2.2.
What distinguishes HOMA-IR from HbA1c? +
HOMA-IR measures insulin sensitivity (how well cells respond to insulin), not blood glucose directly. HbA1c measures long-term blood glucose. HOMA-IR can be elevated before HbA1c rises — it is an earlier marker of metabolic dysregulation.
Can intermittent fasting lower HOMA-IR? +
Yes. Multiple RCTs show that intermittent fasting (16:8 or 5:2) can lower HOMA-IR by 20–30%. The effect is attributable to weight reduction, reduced insulin secretion, and improved glucose sensitivity.
Sources
Last Reviewed: May 28, 2026 · sina
This information is for orientation only and does not replace medical advice. Reference ranges can vary by laboratory, method and country.