HOMA-IR Calculator — Insulin Resistance

If you suspect that you might be insulin resistant (and need some kind of insulin resistance test), the HOMA-IR calculator is the tool just for you. It uses only two values — your fasting insulin and glucose levels — and it counts not only your HOMA-IR parameter but also your QUICKI index. These two values, when put together, give you a better perspective on your health. Read the text to find out what insulin resistance is, if there are any insulin resistance symptoms, and how the HOMA formula calculation is done.

If you're interested in metabolic disorders, try our:

• Hemoglobin A1c calculator;
• CVD risk calculator for cardiovascular diseases; and
• Diabetes risk calculator.

We try our best to make our Omni Calculators as precise and reliable as possible. However, this tool can never replace a professional doctor's assessment. Before administering any drugs, fluids, or treatment to your patient, make sure you know the dose and the method.

HOMA-IR — HOmeostatic Model Assessment for Insulin Resistance — is an index used to determine if insulin resistance is present in a patient. People widely use it because of its simplicity and noninvasive nature. In contrast, the 'gold standard' method for diagnosing insulin resistance (a hyperinsulinemic euglycemic metabolic clamp) involves multiple intravenous administrations of insulin and glucose, along with measuring blood parameters numerous times. Keep in mind that this 'gold standard' method is limited to only scientific purposes.

You can do your own HOMA formula calculation using one of the following equations. The choice depends on the units you prefer to use. Remember that both values refer to the fasting state where nothing has been eaten or drank (other than clear water) for at least 8 hours before the blood sample is drawn.

Use:

HOMA-IR = (insulin × glucose) / 22.5

for the glucose concentration in mmol/L, or:

HOMA-IR = (insulin × glucose ) / 405

for glycemia in mg/dL. In both cases, the insulin is in mU/L.

It is also worth noting that diabetes mellitus type 2 always coexists with insulin resistance (as insulin resistance is a background for the disease), so there might not be a reason to run the test. See the next section to read more about the mechanism.

Insulin is a hormone produced by β-cells (beta-cells) in the pancreas, an organ found in the upper part of your abdomen. Insulin regulates the sugar level in the blood and is secreted when the blood sugar level is high (e.g., after a meal). It works like a door-opening key – by interacting with specialized receptors in the cell membrane, it makes glucose move into fat, skeletal muscle, and liver cells. This results in the following:

a) The cell receiving a source of energy; and,

b) The blood sugar level is lowered.

Insulin resistance is when cells do not react to the insulin delivered to them via the blood. The causes are numerous. Sometimes there's a problem with a receptor. Sometimes, it's an issue with the signaling pathway. To make up for ineffective insulin, the pancreas produces more of it. As long as the amount of insulin available to the cell is sufficient to compensate for its weak response, blood sugar levels will stay in the normal range.

The pancreas usually cannot maintain this state of increased insulin production for long. Pancreas cells become depleted. When this happens, there will be a lot of insulin and sugar in the blood, as they cannot be 'consumed' by the cells. Persistent hyperglycemia — high blood sugar level — has very well-known harmful effects, such as diabetes and an increased risk of cardiovascular disease.

What are some insulin resistance symptoms? The answer is there isn't any until it's too late, as you don't really feel insulin resistance. This is the same as hyperglycemia, where you don't really feel it until it damages your organs or is high enough to give you acidosis.

What is insulin resistance — is it a separate disease? Well, while we address it like an illness — there are drugs and interventions — it's more a state that precedes more severe metabolic disorders, such as diabetes. It's also usually paired with other cardiovascular risk factors, like obesity, lack of physical activity, high blood pressure, and hyperlipidemia. Early intervention and following the doctor's orders are key to saving yourself from serious consequences, such as blindness or kidney failure.

Our HOMA-IR calculator is very easy to use:

1. If you have your parameters ready, remember they need to be fasting values. This means that they were obtained after at least 8 hours of not eating and drinking anything other than water. Some drugs, such as metformin, also can influence the result.
2. Fill in the field for the blood sugar concentration (glucose). You can use the units that are most convenient for you.
3. Input your insulin concentration.
4. Your results are ready. Both your HOMA-IR and QUICKI index will be shown at once.
5. Under the calculator, you will also find some short comments about your results.

Since the HOMA-IR index is so simple to use and requires such little data, it also has many limitations. The first is that it's very hard to set exact cut-offs for everyone at once. It varies between populations, and there is no strict value above which you definitely have insulin resistance. So, treat the results from this calculator as a way of seeing if you have any cause for concern, not as an exact diagnosis.

If you are worried about your health, visit your general practitioner. They will get your medical history, make an examination, run laboratory tests, and then, and only then, can they state if you have this condition or not.

In general, the cut-off value is 2. Any result above this suggests insulin resistance.

QUICKI (QUantitative Insulin sensitivity ChecK Index) is an index used to assess insulin resistance, just like HOMA-IR. It uses exactly the same values: fasting glucose and fasting insulin, but the formula is different:

QUICKI = 1/(log(insulin) + log(glucose)),

where insulin is in mU/L, and glucose is in mg/dL. The smaller the QUICKI index is, the larger the probability there is a carbohydrate metabolism disorder:

• QUICKI index >0.45 — you are probably healthy;

• QUICKI index between 0.30-0.45 — you might be insulin resistant; and

• QUICKI index <0.30 — you might be diabetic.

When it comes to treating insulin resistance, controlling your diet and getting regular physical activity are crucial. It is important to get proper dietary counseling and monitor your eating habits. Here you will find some tips which will help you not only control the insulin resistance symptoms but also affect your health positively:

1. If you're overweight, you should limit the calories you eat every day. You should eat an amount that will cause you to lose weight comfortably (about 0.5 kg per week) until you reach a healthy BMI range.

2. Say bye-bye to jellies and juices. Juices are sometimes seen as healthy because they're fruit-flavored, but they're a source of a huge amount of simple sugars, and they're usually additionally sweetened with sugar.

3. Replace salt with other herbs and spices. Herbs will not only decrease your salt intake but can even affect your metabolism and help you lose weight! Befriend cayenne pepper, basil, and pepper.

4. Choose wholegrain alternatives. This counts for bread, rice, and pasta, as well as for breakfast options (oatmeal over cereals!). They contain larger amounts of fiber and thereby slow down the breakdown of the carbohydrates, preventing you from experiencing sudden blood sugar changes.

5. If you want to eat sweets, take care not to eat them alone. For example, add a handful of nuts to a piece of your favorite chocolate. The same refers to eating fruit — they are healthy and contain vitamins, but they are also full of sugar. Adding a bit of fat (nuts, peanut butter) or protein (quark, egg-fruit omelet, anyone?) will mitigate the influence of the sugar load and will make you full sooner — you probably won't need to eat the whole chocolate bar at once.

6. Eat vegetables every day, at least a few portions. A portion is, e.g., 1 cup of leafy vegetables, one tomato, or 3 heaped tablespoons of cooked vegetables. A good habit is to make your plate as colorful as possible — with different varieties of vegetables!

7. Replace frying with cooking, stewing, or baking. As well as not having to deal with splashing oil, you'll get a much healthier meal.

HOMA-IR results might differ from population to population, so the specific threshold is very difficult to obtain. However, generally speaking, all the values above 2 should raise our concerns regarding insulin resistance.