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Answer · metabolic

What is HOMA-IR and how is it calculated?

Short answer

HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) is a calculated index derived from fasting glucose and fasting insulin. It standardizes the read of insulin resistance and is more sensitive than either input alone. Lower is better.

Reviewed by Dr. Laura PurdyMay 29, 2026

Full answer

HOMA-IR is a calculated index: fasting insulin (µIU/mL) × fasting glucose (mg/dL) ÷ 405. It standardizes the assessment of insulin resistance by combining two early markers into a single number, and it is more informative than either input alone. A HOMA-IR under ~1.0 is generally consistent with good insulin sensitivity; values trending above ~1.5–2.0 suggest emerging insulin resistance and warrant clinical context — body composition, lipids, ApoB, hs-CRP, and trajectory. HOMA-IR is a screening derivation, not a diagnostic gold standard (the euglycemic clamp is), but for routine wellness it is the most useful operational metric. Provider-reviewed pathways use HOMA-IR to identify metabolic drift early enough to act on it.

Educational. Not a substitute for individualized provider review.

References & sources
  • HOMA-IR — Primary source · oMeds
  • Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-05-29

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Related answers

What is insulin resistance?
Insulin resistance is a state where cells respond poorly to insulin, so the pancreas secretes more insulin to maintain normal blood glucose. It precedes type-2 diabetes by years and shows up first in fasting insulin, HOMA-IR, triglyceride/HDL ratio, and ApoB before A1C or fasting glucose drift. It is reversible.
What is fasting insulin?
Fasting insulin measures circulating insulin after an overnight fast. It rises years before fasting glucose or A1c move, making it the earliest mainstream marker of insulin resistance. It is read alongside fasting glucose and the HOMA-IR derivation.
HOMA-IR vs fasting insulin?
HOMA-IR is the standardized derivation; fasting insulin is one of its inputs. HOMA-IR integrates fasting insulin and fasting glucose into a single insulin-sensitivity index, which makes it the more interpretable single number for tracking.
Fasting insulin vs A1c?
Fasting insulin moves first — often years before A1c. A1c is the standard diagnostic for diabetes, but fasting insulin (paired with fasting glucose as HOMA-IR) is the earliest sensitive marker of insulin resistance. The two answer different questions.
Primary source
HOMA-IR