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HOMA-IR: what your insulin resistance score means

HOMA-IR is a score that estimates insulin resistance from one fasting blood test: fasting glucose (mmol/L) × fasting insulin (µU/mL) ÷ 22.5. It is a rough guide, and what counts as high depends on the lab and the people studied.

By the Bodyvault team · · 8 min read

Cover: HOMA-IR explained, with the same blood giving different scores in different labs.

The short answer

  • ÷22.5

    The formula: fasting glucose (mmol/L) × fasting insulin (µU/mL) ÷ 22.5. With glucose in mg/dL, divide by 405

  • 31%

    Typical spread of a single HOMA result around the true value, in the 1985 paper that introduced it

  • 1.3–2.1

    Results from six labs for blood that scored 2.0 in a seventh lab

  • ≈1.5–2.8

    Cut-offs for a “high” score used in studies from different countries

Key findingHOMA-IR is a quick estimate of insulin resistance from one fasting blood test. It is useful for spotting trends and comparing groups. For one person, treat it as a rough guide: compare results from the same lab, and read them with your doctor.

What is HOMA-IR?

Insulin is the hormone that moves sugar from your blood into your cells. Insulin resistance is when the body stops responding well to insulin. To keep blood sugar normal, the body then has to make more insulin.

HOMA stands for “homeostasis model assessment”. It was introduced in 1985. It uses one fasting blood sample to estimate how hard your body works to keep fasting blood sugar steady. If you need a lot of insulin to keep a normal fasting sugar, your score is high. If you need little, it is low.

A HOMA-IR test isn’t a separate test. It is a score worked out from two results: fasting glucose and fasting insulin. For fasting glucose, fasting means no calories for at least 8 hours. Your lab will tell you how to prepare.

How to calculate HOMA-IR

The usual formula is:

HOMA-IR = fasting glucose (mmol/L) × fasting insulin (µU/mL) ÷ 22.5

If your report gives glucose in mg/dL, divide by 405 instead (22.5 × 18 = 405). Insulin in µU/mL is the same as mU/L. For example, take a fasting glucose of 90 mg/dL and a fasting insulin of 9 µU/mL. Then 90 × 9 = 810, and 810 ÷ 405 = 2.0.

Worked examples (our calculation: glucose in mg/dL × insulin ÷ 405)
Fasting glucoseFasting insulinHOMA-IR
81 mg/dL (4.5 mmol/L)5 µU/mL1.0
90 mg/dL (5.0 mmol/L)9 µU/mL2.0
99 mg/dL (5.5 mmol/L)12 µU/mL2.9
108 mg/dL (6.0 mmol/L)15 µU/mL4.0

How well does HOMA-IR work?

How closely HOMA-IR matched other tests in 1985

Correlation across people (1 = a perfect match)

  • Euglycaemic clampthe main hospital test0.88
  • Fasting insulin alone0.81
  • Hyperglycaemic clamp0.69
Source: Matthews et al. (1985), abstract only. The abstract doesn’t say how many people were tested, or who they were.

A clamp is a detailed hospital test where insulin and glucose are given through a drip while blood sugar is checked again and again. HOMA’s big advantage is that it needs only one blood sample.

The team behind HOMA later reviewed how it was being used. By 2004 it had appeared in more than 500 studies. They said it works well for comparing groups in studies. They also warned that the glucose and insulin results must be good, and the scores read with care.

What is a normal HOMA-IR range?

There is no single normal range. Studies set their cut-offs in different ways and in different people. Some called the top 10% to 34% of a population “high”. Others chose the score that best picked out people with metabolic syndrome. That is a cluster of risk factors: a large waist, high blood pressure, high blood fats and high blood sugar.

Cut-offs for a “high” HOMA-IR in different studies

Each study used its own method, so the numbers aren’t directly comparable

  • Thailandtop 10%, 738 people1.55
  • Japantop 10%, 161 people1.7
  • Iranbest at picking out risk, 1,276 people1.8
  • Spain, menbest at picking out metabolic syndrome1.85
  • Finland95% of healthy adults were below this1.9–2.0
  • Swedentop 25%, 4,816 people2.0
  • Spain, women aged 50best at picking out metabolic syndrome2.07
  • United Statestop 34%, 2,804 people2.73
  • Braziltop 10%, 1,317 people2.77
  • Italytop 20%, 225 people2.77
Sources: Gayoso-Diz et al. (2013), Table 1 and Results (Spain, 2,459 adults); Isokuortti et al. (2017), two Finnish population studies. In the Spanish study, the top-10% rule gave a much higher cut-off: 3.46.

In a random sample of 2,459 Spanish adults, the best cut-off was about 1.85 in men and 2.07 in women aged 50. It rose to 2.47 in women aged 70. In two large Finnish studies, 95% of healthy adults scored below 1.9 to 2.0. We didn’t find a large study that set a cut-off for Indian adults.

Why your lab matters

Insulin tests differ from lab to lab. In a 2017 study, blood from 10 people was tested in seven European labs.

The same blood, seven labs

HOMA-IR in each lab for blood that scored 2.0 in Helsinki

  • Helsinki2.0
  • Lab 21.3
  • Lab 31.6
  • Lab 41.8
  • Lab 51.8
  • Lab 62.0
  • Lab 72.1
Source: Isokuortti et al. (2017), abstract only. The labs are numbered in order of their result. The spread between labs was 25%, and it came from the insulin test (25%) rather than glucose (5%).

So one lab’s 2.0 was another lab’s 1.3. That is a big gap when a cut-off is around 2. Compare your results over time from the same lab.

HOMA-IR and PCOS

Insulin resistance is a key feature of polycystic ovary syndrome (PCOS). Even so, the 2023 international PCOS guideline says the insulin tests used in clinics are of limited use and shouldn’t be used in routine care. Read more in our explainer on PCOS exercise and diet.

Claims and evidence

  • ClaimA HOMA-IR above 2 means you have insulin resistance.

    EvidenceThere is no agreed cut-off. Studies used values from about 1.5 to 2.8, set in different ways and in different people.

  • ClaimHOMA-IR is as good as a hospital test.

    EvidenceIn 1985 it matched the main hospital test closely across people (0.88). But a single result was imprecise, with a typical spread of 31%.

  • ClaimYou can compare results from any two labs.

    EvidenceBlood that scored 2.0 in one lab scored from 1.3 to 2.1 in six others, mainly because insulin tests differ.

  • ClaimHOMA-IR can diagnose diabetes.

    EvidenceIt can’t. Prediabetes and diabetes are diagnosed with fasting blood sugar, a glucose drink test or HbA1c.

What this means for you

What this means for you

  • Have the blood test fasting, as your lab asks: usually no calories for at least 8 hours.
  • To work it out, multiply glucose (mg/dL) by insulin (µU/mL) and divide by 405. Or check the value on your report.
  • Compare results from the same lab over time, not results from different labs.
  • Read it with your doctor, alongside fasting blood sugar and HbA1c. It is not a diagnosis.
  • If your result looks high, ask your doctor what it means for you before drawing conclusions.

What the research can’t tell you yet

  • An agreed normal range. Cut-offs vary by country, age, sex and method.
  • Cut-offs for Indian adults. We found no large study that set HOMA-IR cut-offs for Indian adults.
  • Standard insulin tests. Until insulin tests are standardised, results from different labs can’t be compared fairly.
  • Details of the 1985 checks. The original paper is behind a paywall, and its summary doesn’t say who was tested.

How Bodyvault uses this research

When you add a lab report with both fasting glucose and fasting insulin, Bodyvault’s Labs works out HOMA-IR for you. It uses glucose in mg/dL × insulin ÷ 405, the same formula as above. You can enter results by hand, and scanning reports, unlimited reports and trends over time are part of Bodyvault Pro. As the research shows, compare results from the same lab and treat any cut-off as a rough guide.

Share or cite this explainer

Bodyvault (2026). HOMA-IR: what your insulin resistance score means. https://bodyvault.app/blog/homa-ir

The charts on this page may be reused with a link back to it. The underlying data belong to the studies cited below.

Questions

What is HOMA-IR?

A score that estimates insulin resistance from one fasting blood test. It uses your fasting glucose and fasting insulin. A higher score means your body needs more insulin to keep fasting blood sugar normal.

How do you calculate HOMA-IR?

Multiply fasting glucose (mmol/L) by fasting insulin (µU/mL) and divide by 22.5. With glucose in mg/dL, divide by 405 instead. For example, 90 mg/dL × 9 µU/mL ÷ 405 = 2.0.

What is a HOMA-IR test?

It isn’t a separate test. A lab measures fasting glucose and fasting insulin from one blood sample, and the score is worked out from them. Ask your lab how to prepare.

What does HOMA-IR measure?

It estimates insulin resistance while fasting, using a 1985 model of how glucose and insulin balance each other. It doesn’t measure insulin resistance directly.

What is a normal HOMA-IR range?

There is no agreed range. Cut-offs in studies ranged from about 1.5 to 2.8, and 95% of healthy Finnish adults scored below about 2. Labs differ, so ask your doctor to read your result.

Sources

  1. Matthews DR et al. (1985). Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28(7):412–419.
  2. Wallace TM, Levy JC, Matthews DR (2004). Use and abuse of HOMA modeling. Diabetes Care 27(6):1487–1495.
  3. Gayoso-Diz P et al. (2013). 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 13:47.
  4. Isokuortti E et al. (2017). Use of HOMA-IR to diagnose non-alcoholic fatty liver disease: a population-based and inter-laboratory study. Diabetologia 60(10):1873–1882.
  5. Teede HJ et al. (2023). Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Hum Reprod 38(9):1655–1679.
  6. American Diabetes Association Professional Practice Committee (2026). 2. Diagnosis and classification of diabetes: Standards of Care in Diabetes—2026. Diabetes Care 49(Suppl 1):S27–S49.

General information about fitness and nutrition, not medical advice. If you have a health condition, are pregnant or take medication, talk to your doctor before changing your diet or training.

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