Energy & metabolic
Also known as Homeostatic Model Assessment of Insulin Resistance. Measured in index.
HOMA-IR is a calculated index that combines fasting glucose and fasting insulin into a single number describing how resistant the body has become to its own insulin. It is derived rather than measured: fasting glucose in mg/dL multiplied by fasting insulin in µIU/mL, divided by 405. The value of combining them is that neither alone tells the whole story — glucose can be normal because insulin is high, and insulin can be normal because the pancreas is beginning to fail. HOMA-IR captures the relationship between the two, which is what insulin resistance actually is. It is widely used in research and is a practical way to track whether a metabolic intervention is working, because it moves in response to diet, weight loss and exercise well before HbA1c does.
HOMA-IR is calculated as fasting glucose (mg/dL) × fasting insulin (µIU/mL) ÷ 405.
It is invalid in people taking insulin or insulin-secreting medication and should not be used there.
Several Indian studies propose lower cut-offs than the European-derived thresholds in common use.
A rising HOMA-IR means more insulin is required for the same glucose control. It is strongly associated with abdominal fat, fatty liver, raised triglycerides and a high ApoB, and it typically precedes a prediabetes diagnosis by years. It is also the marker most likely to improve first when someone changes what they eat and how they train.
A low HOMA-IR indicates good insulin sensitivity. Very low values are usually favourable, though the index becomes unreliable at the extremes and in people already on insulin or insulin-secreting medication, where it should not be used at all.
| Band | Value |
|---|---|
| Optimal insulin sensitivity | < 1.0 |
| Early resistance | 1.0 – 2.0 |
| Insulin resistance likely | > 2.5Cut-offs proposed for Indian cohorts sit lower than those derived from European populations |
Laboratory intervals vary. Interpret with a physician.
Thresholds for HOMA-IR were largely derived in European-ancestry cohorts, and several Indian studies propose lower cut-offs, consistent with the observation that Indians show metabolic dysfunction at lower body weights. A HOMA-IR that reads unremarkable against a Western reference can still be meaningful here.
Fasting insulin measures how much insulin the pancreas is releasing to hold blood glucose steady after an overnight fast.
HbA1c measures the proportion of haemoglobin in your red blood cells that has sugar attached to it.
ApoB, or apolipoprotein B, is a protein that sits on the surface of every cholesterol particle capable of lodging in an artery wall.
HOMA-IR is a screening index, not a diagnosis, and should be interpreted by a physician alongside the rest of the metabolic panel. It is not valid in people taking insulin or sulfonylureas. Symptoms suggesting frank diabetes warrant prompt assessment regardless of the index.
Fasting glucose (mg/dL) multiplied by fasting insulin (µIU/mL), divided by 405. Where glucose is reported in mmol/L, the divisor is 22.5 instead. Both inputs must come from the same fasted sample or the result is meaningless.
They answer different questions. HbA1c describes average glucose over roughly three months and is the diagnostic test for diabetes. HOMA-IR describes how hard the body is working to achieve that glucose, and moves years earlier. For early detection, HOMA-IR; for diagnosis, HbA1c.
The programme
Peak Brain draws a full blood and urine panel at your home, has a licensed physician read every marker together rather than one at a time, and turns what they find into a ranked 90-day protocol with a retest at the end.
Authorship & review
Written by the Peak Brain clinical team. Assigned clinical reviewer: Dr. Alfia Kaki, MD, PGC — review pending; this page has not yet been signed off.
Published . Last updated .
This page is general health information, not medical advice, diagnosis or treatment. Reference ranges vary between laboratories. Never delay or disregard advice from a qualified health professional because of something you read here. If you think you may have a medical emergency, call your local emergency number.