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EndocrinologyHOMA-IR

HOMA-IR Calculator (HOMA1)

Calculate the original HOMA1-IR index from paired fasting insulin and glucose, with glucose-unit normalization, assay limitations and no universal diagnostic cutoff.

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QuickMedCalc is developed and maintained by an independent developer. Medical content is not independently reviewed by a physician.

Formula and medical content are based on the references listed on this page. See sources, About, and Sources and Review Process.

Use fasting insulin and fasting glucose collected together during the same basal fasting assessment. Do not combine results obtained on different dates or under nonfasting conditions.

Exogenous insulin can affect the measured insulin result, and assay cross-reactivity with insulin analogues varies. This page is limited to a sample intended to reflect endogenous basal insulin secretion.

Select the insulin unit printed on the report.

µU/mL

Enter the fasting insulin value reported in µU/mL or mIU/L; these units are numerically equivalent. This page does not convert insulin from pmol/L.

Select the glucose unit printed on the paired laboratory report.

mg/dL

Enter the fasting glucose value from the paired sample and select the unit printed on the report.

About

HOMA was developed from the fasting steady-state glucose–insulin feedback model. This page uses the original linear HOMA1-IR approximation from paired fasting glucose and insulin as an indirect surrogate of insulin resistance; the hyperinsulinemic-euglycemic clamp is a reference method for direct assessment. HOMA1 is not HOMA2, which is a nonlinear Oxford computer model. Insulin assays remain incompletely harmonized, and results vary with platform, fasting quality, population, age, glucose state, beta-cell function, acute illness and medicines. There is no universal diagnostic threshold across populations and assays. Routine insulin testing is used mainly in research rather than ordinary diabetes diagnosis. Do not use a sample affected by exogenous insulin therapy. This page does not diagnose diabetes, prediabetes, PCOS, metabolic syndrome or insulin resistance and does not determine treatment.

Formula

HOMA1-IR = fasting insulin (µU/mL) × fasting glucose (mg/dL) ÷ 405.
HOMA1-IR = fasting insulin (µU/mL) × fasting glucose (mmol/L) ÷ 22.5.
Glucose (mmol/L) = glucose (mg/dL) ÷ 18.
µU/mL and mIU/L are numerically equivalent for insulin reporting.

Interpretation

What HOMA1-IR estimates

HOMA1-IR is derived from basal fasting glucose and insulin as a steady-state surrogate, not a direct measurement of insulin sensitivity. Different glucose and insulin combinations can produce the same HOMA1-IR value.

Exact arithmetic and units

The formal paths are insulin × glucose (mg/dL) ÷ 405 and insulin × glucose (mmol/L) ÷ 22.5. They are equivalent after the exact glucose conversion. µU/mL and mIU/L are numerically equivalent. This page does not convert insulin from pmol/L, and rounds only the final display.

Fasting and sample requirements

Use insulin and glucose from the same paired fasting collection. Do not combine nonfasting or separately timed values. Acute illness, physiologic stress, recent food and medicines can alter the basal state; this page cannot verify collection quality.

No universal diagnostic cutoff

Proposed cutoffs vary with population, age, BMI, glucose state, study endpoint and insulin assay. Systematic assay differences mean a threshold from one laboratory or study cannot simply be transferred to another. This page provides no automatic category.

HOMA1, HOMA2 and reference methods

HOMA1 is the original linear approximation; HOMA2 is Oxford’s nonlinear computer model and the two are not interchangeable. Clamp studies, IVGTT and OGTT-derived dynamic indices answer different questions. This page does not simulate HOMA2, HOMA-%B or beta-cell function.

Clinical limitations

Exogenous insulin, type 1 diabetes or severe beta-cell failure, acute illness or physiologic stress, marked hypo- or hyperglycemia, pregnancy, childhood or adolescence, PCOS, medicines affecting glucose or insulin, kidney or liver disease, and insulin antibodies or assay cross-reactivity require condition-specific research or clinical pathways. This page neither diagnoses a condition nor selects treatment.

References

  1. Matthews DR, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–419. PMID 3899825. DOI 10.1007/BF00280883.
  2. Levy JC, Matthews DR, Hermans MP. Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care. 1998;21(12):2191–2192. PMID 9839117. DOI 10.2337/diacare.21.12.2191.
  3. Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487–1495. PMID 15161807. DOI 10.2337/diacare.27.6.1487.
  4. Muniyappa R, Lee S, Chen H, Quon MJ. Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Am J Physiol Endocrinol Metab. 2008;294(1):E15–E26. PMID 17957034. DOI 10.1152/ajpendo.00645.2007.
  5. Sacks DB, et al. Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus. Diabetes Care. 2023;46(10):e151–e199. PMID 37471273. PMCID PMC10516260. DOI 10.2337/dci23-0036.
  6. Staten MA, et al.; Insulin Standardization Workgroup. Insulin assay standardization: leading to measures of insulin sensitivity and secretion for practical clinical care. Diabetes Care. 2010;33(1):205–206. PMID 20040676. PMCID PMC2797975. DOI 10.2337/dc09-1206.
  7. Matli B, et al. Distribution of HOMA-IR in a population-based cohort and proposal for reference intervals. Clin Chem Lab Med. 2021;59(11):1844–1851. PMID 34380182. DOI 10.1515/cclm-2021-0643.
  8. University of Oxford Diabetes Trials Unit. HOMA Calculator — Frequently Asked Questions.

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Disclaimer

Educational and informational reference only. Not intended to replace professional medical advice, diagnosis, treatment, or independent verification.