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) |
Agree on your personal target range with your doctor.
↓ What a low value means
A low HOMA-IR points to high insulin sensitivity. Very low values are clinically unremarkable on their own. 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.
✓ What can influence this value
HOMA-IR is calculated from fasting glucose and fasting insulin and is influenced by diet, physical activity (aerobic and strength training increase GLUT4 expression and can lower the value), body weight and abdominal fat, sleep duration, and chronic stress (cortisol inhibits insulin action). Medications such as glucocorticoids, pregnancy, conditions such as PCOS, and a fasting period that was not kept before the blood draw can also change the value. The assessment is made by the treating doctor.
When to test
The blood draw is done fasting, after several hours without food and with water only; the lab states the exact fasting time. Fasting insulin and fasting glucose are drawn simultaneously and HOMA-IR calculated from these values. The value is measured, for example, with overweight, prediabetes, PCOS, fatty liver, or metabolic syndrome. How often it is measured is decided by your doctor.
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.
How are intermittent fasting and HOMA-IR related? +
Studies have observed a decrease in HOMA-IR with intermittent fasting. The main reasons are thought to be weight loss, reduced insulin secretion, and improved glucose sensitivity.
HOMA-IR
Sources
Last updated: May 28, 2026
This information is for orientation only and does not replace medical advice. Reference ranges can vary by laboratory, method and country.