Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

    Disease

    Select...

    Specialty

    Select...

    Chief Complaint

    Select...

    Organ System

    Select...

    Patent Pending

    HOMA-IR (Homeostatic Model Assessment for Insulin Resistance)

    Approximates insulin resistance.
    Favorite

    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:

    Please fill out required fields.

    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.

    Dr. David R. Matthews

    About the Creator

    David R. Matthews, MD, is a Professor of Diabetic Medicine at the University of Oxford. He is the Deputy co-ordinator and member of the Executive and Policy Advisory Committees of the UK Prospective Study of Diabetes (UKPDS), as well as the founder of the Oxford Health Alliance. He is currently investigating the inter-relationships between insulin resistance and beta cell function, and the effects of a low carbohydrate diet in people with and without type 2 diabetes at Churchill Hospital with the Center of Diabetes, in the United Kingdom.

    To view Dr. David R. Matthews's publications, visit PubMed