HOMA-IR is a calculated score, not a separate substance measured in blood, derived from fasting glucose and fasting insulin in the same sample. Practitioners use it to estimate insulin resistance and to catch compensatory hyperinsulinaemia in clients whose fasting glucose and HbA1c still sit within range. Insulin assays differ between labs and an incomplete fast inflates the score, so compare results from the same lab.
| Test type | Calculated score (HOMA1-IR) |
|---|---|
| Measurements required | Fasting glucose and fasting insulin from the same sample |
| Sample and collection | Fasting blood draw at a collection centre |
| Preparation | Fast for 8 to 12 hours before a morning collection, water only. |
| Turnaround | 3 to 5 business days |
| Available through | Diabetes & Glycaemic Studies, part of the Baseline Health Check. Also in: Full Body Health Check, Fasting Insulin Test. |
| Pricing | Included in the $99 Baseline Health Check |
| Results | Returned in the Vively practitioner platform, beside your client's other markers |
What are the HOMA-IR reference and optimal ranges?
| Typical lab reference | Vively optimal | |
|---|---|---|
| Adults | Up to 2.9 (unitless score) | 1.0 or below |
Most labs do not print HOMA-IR, so it is calculated as fasting glucose (mmol/L) multiplied by fasting insulin (mIU/L), divided by 22.5, and insulin assays differ between labs. Read each input against the range on the client's report (RCPA); the optimal range is a target for early work, not a diagnostic cut-off.
Calculate HOMA-IR from fasting glucose and insulin
Enter both fasting values from the same blood draw. The score is worked out in your browser. Nothing you enter is stored or sent.
Formula. HOMA1-IR = fasting glucose (mmol/L) × fasting insulin (mIU/L) ÷ 22.5
This uses the original HOMA1 equation (Matthews and colleagues, 1985), which is the version most labs and papers quote. HOMA2 is a computer model that gives slightly different values, so do not compare the two directly. mg/dL glucose is converted by dividing by 18.016, and pmol/L insulin by dividing by 6.945 (1 mIU/L equals 1 µIU/mL).
Limits. It is not valid for clients on insulin therapy, and the score is less reliable with an incomplete fast, an acute illness or very high glucose. Insulin assays differ between labs, so compare scores from the same lab.
A guide only, not a diagnosis. One result is a starting point: read it with symptoms, history and a repeat test, and check it against the range on your client's report.
How do you arrange HOMA-IR testing through Vively?
- Get verified. Practitioners with a recognised qualification or membership (ATMS, NHAA, ANTA, Dietitians Australia, NSA, CMA or Ahpra registration) can request free practitioner access.
- Choose a panel. Log in to the practitioner platform and pick a panel that includes HOMA-IR, or build your own. It is included in the $99 Baseline Health Check.
- Client collects. Your client collects at a partner collection centre, with their request on their phone or printed.
- Review results. Results come back to you in the practitioner platform, beside your client's other markers, ready for the follow-up consult.
Which Vively panels include HOMA-IR?
Log in to the practitioner platform to view a panel in full, or build and save your own from 100+ tests and panels.
- Baseline Health Check74 markers across 11 lab groups$99
One fasting blood draw.
Full Blood CountUrea, Electrolytes & CreatinineLiver Function TestsCalcium, Phosphate & MagnesiumLipid StudiesDiabetes & Glycaemic StudiesIron StudiesThyroid Function Tests+3 moreLog in to view this panel - Log in to view this panelFull Body Health Check87 markers · Health checksPrice on sign-up
Why does the optimal range sit there?
Three different numbers apply here: the lab reference limit, published research thresholds and Vively's own target. They answer different questions.
The upper limit used as the lab reference on this page. Most labs do not report HOMA-IR, so there is no single lab-set range, and published cut-offs for insulin resistance vary between populations and insulin assays.
The original Oxford model (Matthews and colleagues, Diabetologia, 1985) was calibrated so a lean, young, insulin-sensitive reference population scores about 1.0. That calibration point is not a universal target for every adult.
A Vively target for early, preventive work, not a diagnostic cut-off. Scores between 1.0 and 2.9 sit inside the lab reference but above the target, so they are a prompt to review diet, activity, sleep and weight trend, and to retest.
Wallace, Levy and Matthews (Diabetes Care, 2004) caution that HOMA-IR is most reliable for tracking change, so treat one score as a starting point.
What should HOMA-IR be read with?
- ContextHOMA-IR above 2.9, fasting glucose below 5.5 mmol/L
Often seen with compensatory hyperinsulinaemia, where extra insulin is still keeping glucose in range.
- HighRaised HOMA-IR, high triglycerides, low HDL
A common insulin resistance lipid pattern that may point to metabolic syndrome; check waist and blood pressure.
- HighRaised HOMA-IR with ALT or GGT above range
Possible fatty liver, which often goes with hepatic insulin resistance.
- LowLow HOMA-IR with fasting glucose 7.0 mmol/L or above
Possible falling insulin production; the score is unreliable here and the client needs GP review.
What can affect a HOMA-IR result?
- An incomplete fast: milk in coffee or a late snack lifts insulin more than glucose and inflates the score.
- Different insulin assays between labs, so compare scores from the same lab.
- Hard exercise, poor sleep or acute illness in the 24 hours before collection.
- Corticosteroids and some antipsychotics, which raise insulin resistance.
- Insulin therapy, which makes the score meaningless, and glucose-lowering medicines, which limit its use.
When should you refer the client to their GP?
- Fasting glucose 7.0 mmol/L or above, or HbA1c 48 mmol/mol or above, whatever the HOMA-IR.
- Thirst, frequent urination, unexplained weight loss or recurrent infections.
- Low insulin with high glucose, which can point to falling beta-cell output.
- Fasting glucose below 3.5 mmol/L with high insulin, or episodes of shakiness, sweating or confusion when fasting.
- Pregnancy, or a history of gestational diabetes.
How should a client prepare for a HOMA-IR test?
Copy or print this to send to your client.
Preparing for your HOMA-IR test
- Fast for 8 to 12 hours before a morning collection, water only.
- Skip exercise on the morning of your test, as it can shift your glucose and insulin.
- If you take diabetes medicines, check with your GP before you fast.
- Take your pathology request to any of 4,000+ collection centres. Bring it printed or on your phone.
- Keep taking prescribed medicines as usual unless your doctor tells you otherwise.
- Results usually take 3 to 5 business days and come to your practitioner. Book your results appointment for after that.
How do practitioners use HOMA-IR with clients?
HOMA-IR often moves before glucose and the other metabolic markers, so it gives clients early feedback once a plan starts. Retest after about 12 weeks of steady work on resistance and aerobic training, fibre and protein intake, sleep and stress, using the same lab so the insulin assay matches.
HOMA-IR FAQs
Can a naturopath, nutritionist or dietitian order HOMA-IR through Vively?
Yes. Add it to a client panel on the Vively practitioner platform. It is part of Diabetes & Glycaemic Studies in the $99 Baseline Health Check, and is also in Full Body Health Check and Fasting Insulin Test. No account yet? Request free access.
Are glucose and insulin collected together for HOMA-IR?
Yes. Both values must come from the same fasting sample, because the score uses them together. Values from different days make the score less reliable.
How is HOMA-IR different from HbA1c?
HbA1c reflects average glucose over about three months. HOMA-IR estimates insulin resistance from one fasting glucose and insulin pair, so it can be raised while HbA1c is still within range.
Should I read HOMA-IR or fasting insulin first?
Read fasting insulin first, then the score. In clients without diabetes, most of the movement in HOMA-IR comes from insulin, because glucose is tightly held. A client with insulin of 12 mIU/L and glucose of 4.8 mmol/L scores about 2.6, and it is the insulin result that flags the problem. Use HOMA-IR to track change over time with the same lab.
Is HOMA-IR valid for clients on metformin or insulin?
Not for clients on insulin. Injected insulin swamps their own output, so the score tells you nothing. On metformin the score is still usable but reads lower, because metformin reduces the liver's glucose output and improves insulin sensitivity. Compare against that client's earlier scores rather than the ranges, and agree the plan with their GP.
How is HOMA-IR calculated, and can I check a score myself?
Multiply fasting glucose in mmol/L by fasting insulin in mIU/L, then divide by 22.5. Checking it yourself is useful when a report gives glucose and insulin but no score. Both values must come from the same fasting sample, and the result is a unitless estimate, not a direct measure of insulin action.
How soon can I retest HOMA-IR to show a client their progress?
Retest after about 12 weeks of steady work on diet, training, sleep and stress. HOMA-IR often moves before glucose and HbA1c, so it can show early change. Use the same lab each time so the insulin assay matches, and keep the fasting conditions identical, as milk in coffee or poor sleep can distort the comparison.
References
- Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985. Source
- Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004. Source
- Samaras K, McElduff A, Twigg SM, et al. Insulin levels in insulin resistance: phantom of the metabolic opera? Medical Journal of Australia. 2006. Source
- Royal College of Pathologists of Australasia. RCPA Manual: Insulin. Source