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HOMA-IR An insulin resistance score from glucose and insulin

Also called Homeostatic model assessment of insulin resistance and HOMA Not on a standard checkup Fast for at least 8 hours

The short answer

HOMA-IR is a score that estimates insulin resistance from your fasting insulin and glucose. A score of 1 matches a young, normal-weight adult; the higher it is, the harder your body is working to keep blood sugar normal.1 It’s a rough estimate, with no agreed cutoff, and insulin tests differ between labs.2,3

A good result
Closer to 1 is better.1 No guideline sets a cutoff. Studies put the line for insulin resistance anywhere from about 1.6 to 3.8, and in a US survey the top third of adults started at 2.73.3,4
If yours is high
It can suggest insulin resistance, though there’s no agreed line for it. Check your fasting glucose and HbA1c, which decide whether you have prediabetes, then work on weight and activity, which improve it.5
Should you test?
It’s an optional estimate from the insulin and glucose in one fasting draw, next to fasting glucose and HbA1c, the tests that diagnose prediabetes.1,5 It isn’t standardized. Insulin tests differ between labs,2 and in a study of older adults one score varied by about 30% between tests.7

Check your result

Type the number from your report. It stays on this page.

1 3
  • Sensitive Under 1.0
  • In between 1.0 to 2.9
  • Higher 3.0 or more

Enter your result to see what it means and what to do next.

Got a result from another lab? Ask Picardo about it. The app explains your results, and a physician can follow up.

There’s no agreed cutoff. The 1 comes from the model itself,1 and 3.0 is a rough research line, the one the IRIS trial used for insulin resistance.6 If your fasting glucose is 126 or more, go by your glucose instead. The bar isn’t to scale.

What is a normal HOMA-IR level?

HOMA-IR has no official normal range, and Labcorp doesn’t report it. A score of 1 matches a young, normal-weight adult.1 Above that, cutoffs for insulin resistance vary from study to study, because insulin tests and populations differ:2,3

Sensitive Under 1.0

Insulin sensitive

Your body needs little insulin to keep your fasting blood sugar normal. That’s below the 1 the model sets for a young, normal-weight adult.1

How worried to be

Nothing to worry about.

What to do next
  1. 1 If your fasting glucose was 100 or more, look at that instead. HOMA-IR can’t tell you whether your blood sugar is in range.5
In between 1.0 to 2.9

In between, where studies disagree

A score of 1 is what the model sets for a young, normal-weight adult.1 Most published cutoffs for insulin resistance fall in this range, though overall they run from about 1.6 to 3.8.3 In US national survey data from 1999 to 2002, the top third of adults started at 2.73.4 No single line in this range separates normal from insulin resistant.

How worried to be

Not a worry on its own.

What to do next
  1. 1 Look at your fasting glucose, HbA1c, triglycerides and waist alongside it. They show whether insulin resistance is affecting anything else.5
  2. 2 One score can vary by about 30% between tests, so look for a trend over two or three tests.7
Higher 3.0 or higher

Higher than most published cutoffs

You’re above most published cutoffs, and at or above the 3.0 the IRIS trial used for insulin resistance.3,6 That’s a rough research line, not a diagnosis. In a US study, people in the top quarter of HOMA-IR were more likely to develop type 2 diabetes, even after allowing for their glucose.8

How worried to be

Worth acting on over the next few months. It isn’t urgent.

What to do next
  1. 1 Check your fasting glucose and HbA1c to see whether your blood sugar has started to rise.5
  2. 2 Losing extra weight and being more active improve insulin resistance; see how to lower HOMA-IR below.5
  3. 3 Recheck with the same lab after a few months of change, and look for a trend rather than one number.7
Heart Health panel
$150.90 · HOMA-IR plus 16 more tests, one visit
Order
Or order just the insulin and glucose test, $9.75

What is HOMA-IR?

HOMA-IR reads two dials at once. A normal glucose with little insulin means your body handles sugar easily. The same glucose with a lot of insulin means it’s working harder to get the same result.

HOMA-IR comes from a 1985 model of how your liver and pancreas balance glucose and insulin overnight. On its scale, a young, normal-weight adult scores 1. At the same glucose, twice the insulin means twice the score.1

Its authors built it to estimate insulin resistance without the clamp, a complex research test, and it tracks the clamp fairly well.1,2

How do you calculate HOMA-IR?

Multiply your fasting insulin, in µIU/mL, by your fasting glucose, in mg/dL, then divide by 405. If your glucose is in mmol/L, divide by 22.5 instead.2,7 Both numbers must come from the same fasting draw.

Fasting insulin Fasting glucose HOMA-IR
4 µIU/mL85 mg/dL0.8
10 µIU/mL90 mg/dL2.2
15 µIU/mL100 mg/dL3.7

Insulin × glucose ÷ 405. Both from the same fasting draw.2,7

Why is there no single cutoff for HOMA-IR?

Insulin tests differ between labs, and so do the people studied. Published cutoffs for insulin resistance run from about 1.6 in Thailand to 3.8 in France.3 In US national survey data from 1999 to 2002, the top third of adults started at 2.73.4 In another large US study, which used a different insulin test, the top quarter started at just 1.8.8

The model’s authors say HOMA works best for comparing groups in research. For one person, they advise averaging three insulin samples taken five minutes apart, because insulin is released in pulses. A standard draw takes one.2 A single score can swing by about 30% from one test to the next, and in adults aged 68 to 88 whose average score was 2.7, a change of less than about 2.3 could be noise.7

What does a high HOMA-IR mean?

It goes with a higher risk of type 2 diabetes. In a US study of 5,314 adults without diabetes, those in the top quarter of HOMA-IR were about 6 times as likely to develop diabetes over about 8 years as those in the bottom quarter. After allowing for their fasting glucose, they were about 1.7 times as likely.8

It doesn’t diagnose anything. Prediabetes and diabetes are diagnosed with glucose and HbA1c.5

How to lower HOMA-IR

  • Losing extra weight

    Extra weight causes some insulin resistance on its own, and losing it improves how well your body responds to insulin.5

    How much it helps
    A lot
    How sure we are
    Very sure
  • Regular physical activity

    Improves insulin resistance, and too little activity raises the risk of type 2 diabetes.5

    How much it helps
    Some
    How sure we are
    Very sure
  • GLP-1 and related weight-loss drugs

    In people with obesity or overweight without diabetes, insulin resistance fell over about 36 weeks on tirzepatide, then levelled off. The improvement went mostly with the weight they lost.9

    How much it helps
    A lot
    How sure we are
    Fairly sure

Who should get a HOMA-IR test?

Guidelines screen with glucose and HbA1c.5 HOMA-IR is an optional estimate on top of those, never a replacement. It helps most if they’re normal but you have signs linked to insulin resistance, such as dark velvety skin patches or fatty liver.5

It isn’t meant for people who inject insulin. The model hasn’t been validated for them.2

How to get a HOMA-IR test, and what it costs

It comes from the insulin and glucose test, which costs $9.75 through Picardo. The Heart Health panel adds 16 more tests from the same visit for $150.90.

Recommended

Heart Health panel

$150.90
17 tests · fast for 12 hours first

The panel measures fasting insulin and glucose from the same draw, so you can work out HOMA-IR. It adds HbA1c, an insulin resistance score from an advanced cholesterol test, uric acid, and kidney and liver tests. See what’s in it

Order the Heart Health panel
Just this test

Insulin and glucose test

$9.75
Labcorp 004333 and 001032 · fast for at least 8 hours

The test this number comes from.

Order the insulin and glucose test
  • Results in 2 to 3 days, in the app
  • Physician follow-up if you want one
  • Free Labcorp draw, or $75 at home
  • No other fees. HSA and FSA eligible.

It’s also part of the Base Core Annual – Men, Base Core Annual – Women and Celiac / GI panels, if you want a wider checkup.

Already have a result? Ask Picardo about it

Questions people ask

Can I use HOMA-IR if I take metformin?

With care. In the UK Prospective Diabetes Study, average insulin sensitivity on HOMA improved in the first year on metformin and stayed better for six years, in people with type 2 diabetes.2 One person’s single score can’t show whether the drug is working.7 It isn’t meant for people who inject insulin.2

Is a HOMA-IR of 2.5 insulin resistant?

It depends on the cutoff. It’s above many published cutoffs, but below the 2.73 that marked the top third of adults in a US survey.3,4 Your waist, triglycerides, glucose and HbA1c help decide.

What’s the difference between HOMA-IR and HOMA2?

HOMA2 is an updated computer version of the same model, recalibrated for modern insulin tests. It gives somewhat different numbers from the simple formula, so compare like with like.2

Can I work out HOMA-IR from a test that wasn’t fasting?

No. The model assumes the overnight balance between your liver and pancreas, so both numbers must come from a fasting sample.1,2

Is HOMA-IR better than fasting insulin alone?

Not by much once you know your glucose. In a large US study, the top quarter of HOMA-IR carried more diabetes risk than the top quarter of insulin, about 6 times against 3.8. After allowing for fasting glucose, the two were similar, about 1.7 against 1.6.8

Often checked alongside

Fasting insulin
An early sign of insulin resistance
Fasting glucose
Blood sugar after an overnight fast
LP-IR
An insulin resistance score from a cholesterol test
HbA1c
Average blood sugar over three months

Test details

Labcorp tests
Insulin, 004333; Glucose, 001032
LOINC
47214-2
Sample
Blood
Fasting
At least 8 hours, water only5
Typical lab range
None. Labcorp reports insulin and glucose, not HOMA-IR.
Formula
Insulin (µIU/mL) × glucose (mg/dL) ÷ 405. With glucose in mmol/L, divide by 22.5.2,7
Units
None. It’s a score.

Sources

  1. 1 Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–419. doi.org/10.1007/BF00280883
  2. 2 Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487–1495. doi.org/10.2337/diacare.27.6.1487
  3. 3 Gayoso-Diz P, Otero-González A, Rodriguez-Alvarez MX, et al. Insulin resistance (HOMA-IR) cut-off values and the metabolic syndrome in a general adult population: effect of gender and age: EPIRCE cross-sectional study. BMC Endocr Disord. 2013;13:47. doi.org/10.1186/1472-6823-13-47
  4. 4 Sumner AE, Cowie CC. Ethnic differences in the ability of triglyceride levels to identify insulin resistance. Atherosclerosis. 2008;196(2):696–703. doi.org/10.1016/j.atherosclerosis.2006.12.018
  5. 5 American Diabetes Association Professional Practice Committee for Diabetes. 2. Diagnosis and classification of diabetes: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S27–S49. doi.org/10.2337/dc26-S002
  6. 6 American Diabetes Association Professional Practice Committee for Diabetes. 3. Prevention or delay of diabetes and associated comorbidities: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S50–S60. doi.org/10.2337/dc26-S003
  7. 7 Poon AK, Meyer ML, Reaven G, et al. Short-term repeatability of insulin resistance indexes in older adults: the Atherosclerosis Risk in Communities Study. J Clin Endocrinol Metab. 2018;103(6):2175–2181. doi.org/10.1210/jc.2017-02437
  8. 8 Mackey RH, Mora S, Bertoni AG, et al. Lipoprotein particles and incident type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis. Diabetes Care. 2015;38(4):628–636. doi.org/10.2337/dc14-0645
  9. 9 Mari A, Stefanski A, van Raalte DH, et al. Tirzepatide treatment and associated changes in β-cell function and insulin sensitivity in people with obesity or overweight with prediabetes or normoglycemia: a post hoc analysis from the SURMOUNT-1 trial. Diabetes Care. 2025;48(9):1622–1627. doi.org/10.2337/dc25-0763

Updated 3 Nov 2026.

This is general health information, not medical advice: talk to your clinician about your results and before changing any treatment.