Calculator Guides
HOMA-IR: Insulin Resistance Assessment in Clinical Practice
HOMA-IR uses fasting glucose and fasting insulin to estimate insulin resistance. General reference: HOMA-IR >2.5–3.0 suggests insulin resistance in most Western populations; >3.6–4.0 suggests significant IR associated with metabolic complications. Always interpret in clinical context.
TL;DR: HOMA-IR uses fasting glucose and fasting insulin to estimate insulin resistance. No universal cutoff exists — values vary by ethnicity, age, sex, and lab method. General reference: HOMA-IR >2.5–3.0 suggests insulin resistance; >3.6–4.0 suggests significant IR.
How to Calculate HOMA-IR
HOMA-IR = [Fasting Glucose (mmol/L) × Fasting Insulin (mIU/L)] / 22.5
For glucose in mg/dL: HOMA-IR = [Fasting Glucose (mg/dL) × Fasting Insulin (mIU/L)] / 405
Clinical Applications
Type 2 Diabetes Risk Stratification
HOMA-IR identifies insulin-resistant individuals at elevated risk for T2DM progression even when fasting glucose is normal.
PCOS Diagnosis and Management
Insulin resistance is present in approximately 65–70% of women with PCOS. HOMA-IR guides metformin initiation.
NAFLD/MASLD Staging
HOMA-IR ≥2.5 is present in virtually all patients with NAFLD and correlates with histological severity.
Evidence
Horáková D et al. (2019) defined HOMA-IR cutoffs in 3,539 Czech adults. Optimal cutoff between non-diabetics and diabetics: 3.63. AUC 0.73.
References
- Horáková D, et al. Medicina (Kaunas). 2019;55(5). PMID: 31108989.
- Matthews DR, et al. Diabetologia. 1985;28(7):412–419. PMID: 3899825.
- Levy JC, et al. Diabetes Care. 1998;21(12):2191–2192. PMID: 9839117.