Measures the blood level of insulin secreted by the pancreas. Together with glucose, it is used to calculate HOMA-IR for evaluation of insulin resistance.
Indication
- Assessment of insulin resistance and metabolic syndrome
- Screening for prediabetes (before type 2 diabetes)
- Evaluation in polycystic ovary syndrome (PCOS)
- Unexplained weight gain or inability to lose weight
- Investigation of episodes of hypoglycemia (low blood sugar)
- Assessment of obesity in children
- Follow-up of hepatic steatosis (fatty liver)
Preparation
- Fasting for 8-12 hours is required
- Nothing other than water should be consumed before the test
- Strenuous exercise should be avoided on the morning of the test
- Diabetes medications in use should be reported to the physician
- The test is performed simultaneously with fasting glucose measurement
How it's performed
- A venous blood sample is drawn from the arm in the morning while fasting
- Blood is collected for glucose and insulin at the same time
- Insulin is measured in the laboratory by an immunological method
- Insulin resistance is calculated using the HOMA-IR formula: (Fasting glucose × Fasting insulin) / 405
- If needed, evaluation is combined with an oral glucose tolerance test (OGTT)
Post-procedure
- Fasting insulin levels vary by age, sex, and laboratory; a typical reference range is 2-25 mIU/L
- HOMA-IR > 2.5 is generally interpreted in favor of insulin resistance
- The result is interpreted together with fasting glucose, HbA1c, and clinical findings
- Lifestyle recommendations (nutrition, exercise, weight control) are the priority approach
- Pharmacological treatment for insulin resistance may be considered if needed
Risks
- Local bruising or transient pain after blood draw
- Very rare vasovagal reaction
- Falsely elevated result if fasting duration is insufficient
- Stress, acute illness, and certain medications may affect the result
FAQ
What does insulin resistance mean?
Decreased sensitivity of body cells to insulin; this leads the pancreas to produce more insulin and may cause diabetes to develop over time.
What does HOMA-IR show?
It is a simple formula calculated from fasting glucose and insulin levels; it provides an estimate of the presence and severity of insulin resistance.
Is fasting required for the test?
Yes; at least 8-12 hours of fasting is required, otherwise the result will be elevated and cannot be interpreted accurately.
Can insulin resistance be treated?
It can be substantially improved with dietary changes, weight control, and regular exercise; medication may be added when needed.
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