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HOMA-IR – Test for Insulin Resistance

PBTT

Private Blood Tests Team

Clinical Team

29 Dec 2025•12 min read

If you are concerned about your risk of developing type 2 diabetes, or you have been told you have "borderline" blood sugar, you may have heard about the HOMA-IR test. This increasingly popular assessment provides valuable insights into your metabolic health that standard glucose tests simply cannot offer.

This comprehensive guide covers everything you need to know about the HOMA-IR test — what it measures, how to prepare, what your results mean, and why it matters for your health.

What Is the HOMA-IR Test?

HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) is a blood test that calculates your level of insulin resistance using measurements of fasting insulin and fasting glucose.

Unlike standard diabetes tests that focus primarily on blood sugar levels, HOMA-IR examines the relationship between glucose and the insulin required to maintain it. This provides a more complete picture of your metabolic health.

The test measures:

  • Fasting blood glucose (sugar)
  • Fasting insulin

    • The HOMA-IR score is calculated using the formula:

    HOMA-IR = (Fasting Insulin × Fasting Glucose) ÷ 22.5

    A higher score indicates greater insulin resistance — meaning your body needs more insulin to maintain normal blood sugar levels.

    How Is the Test Performed?

    ### Preparation

    Proper preparation is essential for accurate HOMA-IR results:

    Fasting requirements:

  • Fast for 8-12 hours before the test
  • Water is permitted (and encouraged) during the fast
  • Avoid alcohol for 24 hours before testing
  • Take your usual medications unless advised otherwise

    • Timing considerations:

  • Morning appointments are ideal (after overnight fasting)
  • Try to schedule at a consistent time if doing serial testing
  • Avoid strenuous exercise the evening before

    • What can affect results:

  • Recent illness or infection
  • Certain medications (steroids, some blood pressure medications)
  • Extreme stress
  • Poor sleep the night before
  • Recent high-carbohydrate meals (even days before)

    • ### The Blood Draw

    The test itself is straightforward:

  • A small blood sample is taken from a vein in your arm
  • The procedure takes only a few minutes
  • You may feel a brief pinch when the needle is inserted
  • Minimal bruising may occur at the site

    • For general information about what to expect during blood testing, read our comprehensive overview of blood testing procedures.

    ### Results

    Results are typically available within 24-48 hours. You will receive:

  • Fasting glucose level
  • Fasting insulin level
  • Calculated HOMA-IR score

    • Interpreting Your HOMA-IR Score

    Understanding what your score means is crucial for taking appropriate action:

    ### Score Below 1.0 — Optimal Insulin Sensitivity

    This indicates excellent metabolic health:

  • Your cells respond efficiently to insulin
  • Your pancreas produces appropriate amounts of insulin
  • Low risk of developing type 2 diabetes
  • Continue current healthy lifestyle habits

    • ### Score 1.0 to 1.9 — Normal Range

    Your insulin sensitivity is within healthy limits:

  • No immediate concerns
  • Maintain healthy diet and exercise habits
  • Annual monitoring recommended if risk factors present

    • ### Score 2.0 to 2.9 — Mild Insulin Resistance

    Early insulin resistance is developing:

  • Your pancreas is working harder than it should
  • Excellent opportunity for lifestyle intervention
  • Dietary and exercise changes typically effective
  • Retest in 3-6 months to assess improvement

    • ### Score 3.0 to 4.9 — Moderate Insulin Resistance

    Significant metabolic dysfunction:

  • Notable reduction in insulin sensitivity
  • Increased risk of progressing to prediabetes
  • Lifestyle intervention essential
  • Consider additional metabolic testing
  • Medical guidance recommended

    • ### Score 5.0 and Above — Severe Insulin Resistance

    Marked metabolic impairment:

  • High risk of diabetes and associated conditions
  • May already have prediabetes or early diabetes
  • Comprehensive medical evaluation needed
  • Aggressive intervention required
  • Consider additional testing including HbA1c

    • For information about HbA1c testing, read our guide to understanding the A1C blood test.

    Why HOMA-IR Matters for Early Detection

    ### The Timeline of Diabetes Development

    Type 2 diabetes does not develop overnight. The typical progression:

    Stage 1: Normal (Years 0-5)

  • Insulin sensitivity normal
  • Blood glucose normal
  • HOMA-IR optimal

    • Stage 2: Compensated Insulin Resistance (Years 5-15)

  • Insulin resistance developing
  • Pancreas compensates by producing more insulin
  • Blood glucose remains normal
  • HOMA-IR elevated — THIS IS WHEN IT IS DETECTED

    • Stage 3: Prediabetes (Years 15-20)

  • Pancreas cannot fully compensate
  • Blood glucose starting to rise
  • HbA1c becomes elevated
  • Standard tests begin showing abnormalities

    • Stage 4: Type 2 Diabetes

  • Significant glucose elevation
  • Diabetes diagnosed
  • Complications may have already begun

    • HOMA-IR identifies problems at Stage 2 — potentially 10-15 years before diabetes would be diagnosed by conventional testing.

    Who Should Get Tested?

    ### High-Risk Groups

    HOMA-IR testing is particularly important for:

  • Family history: Parents or siblings with type 2 diabetes
  • Weight concerns: Overweight or obese, especially with abdominal fat
  • Metabolic syndrome: High blood pressure, abnormal cholesterol, elevated triglycerides
  • Women with PCOS: Insulin resistance is common in polycystic ovary syndrome
  • Gestational diabetes history: Previous diabetes during pregnancy
  • Ethnic background: Higher risk in South Asian, African-Caribbean, and Middle Eastern populations

    • ### Symptom-Based Indications

    Consider testing if you experience:

  • Fatigue, especially after eating
  • Difficulty losing weight despite efforts
  • Intense sugar or carbohydrate cravings
  • Frequent hunger
  • Brain fog or difficulty concentrating
  • Skin tags
  • Dark, velvety skin patches (acanthosis nigricans)

    • For more about symptoms that warrant investigation, read our article on when stress might be something more.

    ### Proactive Health Monitoring

    Even without risk factors, HOMA-IR can be valuable for:

  • Establishing metabolic baseline
  • Annual health assessments
  • Tracking response to lifestyle changes
  • Optimising athletic performance
  • Longevity-focused health protocols

    • HOMA-IR as Part of Comprehensive Testing

    For the most complete metabolic assessment, HOMA-IR should be considered alongside:

  • HbA1c — Average blood sugar over 2-3 months
  • Lipid profile — Cholesterol and triglycerides
  • Liver function tests — NAFLD is linked to insulin resistance
  • Inflammatory markers — CRP and others
  • Thyroid function — Can affect metabolism

    • For comprehensive testing information, read our guide to what's included in a comprehensive health check.

    Improving Your HOMA-IR Score

    If your score is elevated, evidence-based strategies can help:

    ### Dietary Interventions

  • Reduce refined carbohydrates and added sugars
  • Increase dietary fibre
  • Choose whole, unprocessed foods
  • Consider Mediterranean-style eating patterns
  • Time-restricted eating may help some individuals

    • ### Exercise

  • Both aerobic and resistance training improve insulin sensitivity
  • Even moderate activity like walking is beneficial
  • Post-meal walks help manage glucose spikes
  • Consistency is more important than intensity

    • ### Weight Management

  • Even 5-10% weight loss significantly improves insulin sensitivity
  • Focus on sustainable changes rather than rapid loss
  • Abdominal fat loss is particularly beneficial

    • For more on weight and hormones, read our article on how hormones affect weight gain.

    ### Sleep and Stress

  • Poor sleep directly impairs insulin sensitivity
  • Chronic stress elevates cortisol, worsening insulin resistance
  • Both are modifiable and important targets

    • Monitoring and Follow-Up

    Regular retesting helps track progress:

  • After lifestyle changes: Retest in 3 months to assess response
  • Stable elevated scores: Retest every 6 months
  • Normal scores with risk factors: Annual testing
  • Optimal scores: Consider including in routine health checks

    • HOMA-IR Testing in London

    At Private Blood Tests London, we offer HOMA-IR testing at our CQC-registered clinic in South Kensington. Our comprehensive metabolic panels include fasting glucose, fasting insulin, and calculated HOMA-IR score, providing you with actionable information about your insulin sensitivity.

    For related testing, explore our [diabetes screening options](/diabetes-test) and learn about the [glucose tolerance test](/blog/glucose-tolerance-test-an-important-tool-for-detecting-diabetes).

    Early detection means early intervention. Do not wait for diabetes to develop when you can identify and address insulin resistance years in advance. Book your HOMA-IR test today and take control of your metabolic health.

    Ready to Book Your Test?

    Visit our CQC-registered clinic in South Kensington for professional blood testing services.

    Book AppointmentContact Us

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