Free Tool

HOMA-IR: what your fasting insulin is actually telling you

The insulin resistance score you can work out from two numbers on a standard panel — and the honest truth about what it can and can't say.

Your HOMA-IR
1.78
012345+

The bar shows published reference points, not a diagnosis. US adults without diabetes had a median around 2.2 in NHANES III; commonly used US thresholds sit between 2.0 and 3.0; cut points reported for Asian populations run lower, roughly 1.4–2.5.

Why there is no "normal" number here

Almost every HOMA-IR calculator online will hand you a number and a verdict. The verdict is the part that isn't supported. There is no universally accepted cutoff for HOMA-IR. Thresholds in common use in the US fall somewhere between 2.0 and 3.0 — NHANES uses 2.5 — while cut points reported in Asian populations run lower. The score also isn't attached to any validated treatment algorithm: no guideline says "at this number, do this."

That doesn't make it useless. It makes it a trend instrument rather than a verdict machine. Your own HOMA-IR measured the same way, in the same lab, six months apart, is a far more informative number than your HOMA-IR compared to a threshold from a study population you may not resemble.

The caveat the original authors made and almost nobody repeats: the simple formula this page uses — HOMA1 — is described by Matthews and colleagues as a crude approximation of their actual model, reasonable near normal glucose and insulin values and less so away from them. It was derived from normal-weight adults under 35. The authors built a corrected computer model, HOMA2, recalibrated for modern insulin assays, and they recommend using it where possible. If your numbers are far from the normal range, treat the figure above as a rough orientation and the HOMA2 calculator as the better instrument.

Getting the inputs right

What the number is made of

UnitsFormula
Glucose mg/dL(fasting glucose × fasting insulin) ÷ 405
Glucose mmol/L(fasting glucose × fasting insulin) ÷ 22.5

Insulin is in µIU/mL in both (sometimes written mIU/L — the same thing). If your lab reports insulin in pmol/L, this page divides by 6.0 to convert. The model was scaled so a healthy young adult sits near 1.

What moves it is what moves insulin sensitivity generally: sleep, muscle, movement after meals and what the meal was made of. If you want the graded evidence on each of those rather than claims, the Evidence Library is the honest version.

Educational tool only — not a diagnostic tool, not medical advice, and not a substitute for the interpretation of your own clinician, who can see the rest of your results. Nothing you enter here is stored or sent anywhere.

Sources

  1. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–419. pubmed.ncbi.nlm.nih.gov/3899825
  2. Levy JC, Matthews DR, Hermans MP. Correct homeostasis model assessment (HOMA2) evaluation uses the computer program. Diabetes Care. 1998;21(12):2191–2192. pubmed.ncbi.nlm.nih.gov/9839117
  3. MDCalc. HOMA-IR — interpretation and cutoff caveats. mdcalc.com/calc/3120

What now?

One score is a snapshot. The pattern underneath it is the thing worth changing.

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