HOMA‑IR

The index was described in 1985 by Matthews and colleagues; in addition, there is the further-developed, computer-based HOMA2 model. Original publication, University of Oxford: HOMA2.

HOMA-IR (HOMA-IR stands for: Homeostasis Model Assessment of Insulin Resistance) is a calculated index used to estimate insulin resistance. It is determined based on fasting blood glucose and fasting insulin levels.

Calculation: When glucose is given in mg/dl

• HOMA-IR = fasting insulin (μU/ml) × fasting glucose (mg/dl): 405

The higher the HOMA-IR, the lower the insulin sensitivity is usually. The following are often used as a rough guide:

   HOMA-IR Assessment

• < 1.0 high insulin sensitivity
• 1.0–2.0 usually normal
• 2.0–2.5 possible borderline range
• > 2.5 Indication of insulin resistance
• > 5.0 marked insulin resistance likely

However, there is no universally applicable cutoff value. Age, body weight, ethnicity, the population studied, and the insulin assay used significantly influence the reference ranges.

The HOMA-IR is particularly suitable for:

• epidemiological and scientific studies,
• longitudinal studies,
• as a supplementary assessment for metabolic syndrome, obesity, prediabetes, or polycystic ovary syndrome.

It is not a standalone diabetes test and does not replace fasting glucose, HbA1c, or the oral glucose tolerance test. Its diagnostic value is limited in cases of impaired β-cell function, established diabetes, or insulin therapy.

The hyperinsulinemic-euglycemic clamp is considered the reference method for measuring insulin sensitivity (The hyperinsulinemic-euglycemic clamp is an experimental procedure for the quantitative determination of insulin sensitivity. It is considered the reference or gold standard for measuring insulin resistance. The procedure was established in 1979 by DeFronzo and colleagues).

1. Tahapary DL et al. (2022) Challenges in the diagnosis of insulin resistance: Focusing on the role of HOMA-IR and the triglyceride/glucose index. Diabetes Metab Syndr 16:102581.