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HOMA-IR (Homeostatic Model Assessment of Insulin Resistance)

HOMA-IR = fasting glucose (mg/dL) × fasting insulin (µU/mL) ÷ 405 (or glucose in mmol/L × insulin ÷ 22.5). Higher values mean more insulin resistance; there is no universal cut-off, but values above about 2.5 are commonly taken to suggest insulin resistance in adults.

  • Fasting glucose (mg/dL or mmol/L)
  • Fasting insulin (µU/mL or pmol/L)
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Interpretation

ResultMeaning
≈ 1Normal insulin sensitivity
> 2.5Commonly used threshold for insulin resistance (population-dependent)

Formula

HOMA-IR = glucose (mg/dL) × insulin (µU/mL) ÷ 405 = glucose (mmol/L) × insulin ÷ 22.5. HOMA-%β = 20 × insulin ÷ (glucose mmol/L − 3.5).

Clinical pearls

  • Use simultaneous fasting samples; insulin assays vary between labs, so cut-offs are not portable.
  • Insulin conversion here uses 1 µU/mL = 6 pmol/L (some labs use 6.945).
  • Not valid in patients on insulin therapy.

Examples

homa-ir glucose 100 insulin 10insulin resistance fasting glucose 5.5 mmol/L insulin 18calculate homa for fasting sugar 90 mg/dL and fasting insulin 20

FAQ

What is a normal HOMA-IR?

Around 1 in lean, healthy adults. Cut-offs for insulin resistance range from roughly 1.7 to 3.0 depending on the population and insulin assay; 2.5 is often used.

How do I calculate HOMA-IR in mmol/L?

Multiply fasting glucose (mmol/L) by fasting insulin (µU/mL) and divide by 22.5.

Evidence

  1. Matthews DR et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.

Endocrine & Metabolic · Reviewed 2026-10-14 · Methodology