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    Patent Pending

    HOMA-IR (Homeostatic Model Assessment for Insulin Resistance)

    Approximates insulin resistance.
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    INSTRUCTIONS

    All scores are calculated in mg/dL.
    When to Use
    Pearls/Pitfalls
    Why Use

    Patients evaluated for potentially impaired glucose tolerance and diabetes.

    The score, a shortcut for estimating insulin resistance (IR), has been examined in multiple studies. Results typically show reasonable correlation between HOMA-IR and ‘clamp’ measurement, the gold standard. However agreement levels between the two, a more important gauge for individual accuracy and clinical use, are weak, suggesting more research and refinement are needed for clinical use.

    Clamp methods for measuring IR are resource intensive, invasive and time consuming, and IR can be a useful metric. An estimate of IR may help decision making.

    mIU/L
    mg/dL

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    The HOMA-IR score may be most useful for epidemiologic, population-based, and other group level assessments. In addition, optimal diagnostic cutoffs for IR-related conditions seem to vary considerably from one population or group to the next so care should be taken to customize cutoffs when using the score.

    Management

    We are unaware of validated management algorithms using the HOMA-IR score.

    Critical Actions

    The HOMA-IR score should not be used in patients on insulin, and studies have questioned its accuracy in those with impaired glucose tolerance, normal BMI, the elderly, and others.

    About the Creator
    Dr. David R. Matthews
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