## HOMA-IR: What it is & why you should know yours

HOMA-IR, The Insulin Resistance Calculation: Insulin x Glucose÷405

[A HOMA-IR calculator is here – you can also Convert to S.I. units here.]

Optimal Range: 1.0 (0.5–1.4)

• Less than 1.0 means you are insulin-sensitive which is optimal.
• Above 1.9 indicates early insulin resistance.
• Above 2.9 indicates significant insulin resistance.

For example:

• If you have a fasting insulin that is on the high side, like 10 uIU/mL
• and your fasting glucose was slightly high too, say 100 mg/dL
• 10 x 100 = 1000, divided by 405 = about 2.5 = early insulin resistance!

HOMA-IR stands for Homeostatic Model Assessment of Insulin Resistance. The meaningful part of the acronym is the IR “Insulin Resistance” part. This calculation marks for both the presence and extent of any insulin resistance that you might currently express. You can visit TheBloodCode.com to plug in your values and get the calculation. It is a terrific way to reveal the dynamic between your baseline (fasting) blood sugar and the responsive hormone insulin.

Low HOMA-IR means that you are sensitive to insulin. A small amount of the hormone insulin is doing the trick to keep your blood sugars in good balance.

High HOMA-IR relates to your level of insulin resistance. The higher the number, the more resistant you are to the message of insulin. If you are above 2, your self-prescribed diet and fitness habits will bring your number down into the lower insulin-sensitive range.[i]

Blood Sugar get’s too much attention. As you can tell, metabolic health lies in space between the hormone insulin and your glucose sensitivity. Since high blood sugar get’s all the press, what is the story behind low and high insulin?

Low insulin: Labs cannot currently detect insulin lower than 2 uIU/mL. The result is reported as “below detectable limits.” If there is no detectable fasting insulin, <2 uIU/mL (<12 pmol/L), and the blood sugar is significantly elevated, such as with a HgbA1C >6.2% (>44 mmol/L), this could be type 1 diabetes, and should be immediately reviewed by a doctor. There is an adult-onset type 1 diabetes called LADA, sometimes referred to as diabetes type 1.5; more-advanced blood tests, including antibody tests, can help to evaluate for the presence of this condition, and should be done through your health-care provider.

With low insulin, you can readily break down fats that you have stored. In my practice, I see low insulin with:

• people with inadequate caloric intake
• people who over-exercise/over-train without adequate time off to recover
• people who have chosen a low-carbohydrate and high fat diet.

High insulin: High insulin on a fasting blood test means you are in an anabolic state—effectively building fat and muscle effectively. High fasting insulin is rare in a thin and frail person and promotes a bigger body, an athletes blessing but overweight person’s curse. Future risk of type 2 diabetes begins to go up in those with fasting insulin above 8 uIU/mL (48 pmol/L).[i] Uncorrected high insulin will usually, over time, result in insulin resistance.

[i] da Silva, R. C., et al. Insulin resistance, beta-cell function, and glucose tolerance in Brazilian adolescents with obesity or risk factors for type 2 diabetes mellitus. J Diabetes Compl. 2007 Mar/Apr; 21(2):84–92.

[i] Vogeser, M. Fasting serum insulin and the homeostasis model of insulin resistance (HOMA-IR) in the monitoring of lifestyle interventions in obese persons. Clinical Biochemistry (2007), vol. 40, issue 13/14:964–8.