HOMA-IR test: insulin resistance in one number

A HOMA-IR test is two fasting measurements and one sum. The lab measures your fasting glucose and your fasting insulin. Your HOMA-IR follows from those.

Your glucose is reported in mmol/l. Your insulin is usually in mU/l. The lab shows each value next to its own reference range. The HOMA index is the score that follows from the two.

A single glucose value tells you half the story. Glucose and insulin together tell you how hard your body is working to keep that glucose normal.

Both glucose and insulin have to be drawn fasting. So fast for 8 to 12 hours beforehand. Water is fine. Avoid alcohol the evening before.

Have your blood drawn in the morning if you can. A non-fasting sample makes your HOMA-IR unreliable. The result then says very little.

The panel measures and reports three things:

• Glucose (fasting) is your blood sugar after fasting, in mmol/l.
• Insulin (fasting) is the hormone that moves glucose into your cells.
• HOMA-IR is the score that follows from those two values.

So you get a glucose measurement, an insulin measurement and your HOMA test in one appointment.

Insulin resistance often develops unnoticed. Your cells respond less well to insulin. Your body then makes more of it. Your fasting insulin rises while your glucose still looks normal.

A single glucose measurement misses that phase. A HOMA-IR test does not, because it weighs both values against each other.

• Athletes who want to see how training and nutrition relate to their insulin sensitivity
• People working on body composition who want to follow their numbers
• People whose glucose or insulin was on the high side before
• People who want a baseline before they change their lifestyle

Your HOMA-IR appears on your result next to your individual values. A higher score points to lower insulin sensitivity. A lower score points to more.

There is no cut-off that applies everywhere. The score depends on the insulin assay used and on the group studied. So read your number as a direction, not as a boundary.

Insulin resistance plays a role in type 2 diabetes. This test does not, however, make a diagnosis. One score also does not mean you are at increased risk. Only your doctor can judge that, alongside your other information.

There are several ways to look at your sugar metabolism. They do not measure the same thing.

• HOMA-IR weighs two fasting values against each other. It is a snapshot of your insulin sensitivity.
• HbA1c shows how your blood sugar has averaged over the past two to three months.
• A glucose tolerance test looks at how fast your glucose falls after a sugary drink. That one runs through a hospital.

The first two need one tube of blood. The third needs several measurements across two hours. So the fasting route is the easiest one to plan.

The test is a fasting blood draw at a certified sample point. There are 700+ locations across the Netherlands. After ordering you pick a location and plan your visit.

A home test does not work for this. A finger-prick is not accurate enough for insulin. Trained professionals draw the blood in the lab instead.

People often choose one at moments like these:

• When they change their nutrition or body composition and want to follow the effect
• When they want insight into their metabolism alongside their training
• When glucose or insulin was high before and they want to keep following it
• When they repeat the test periodically to see a trend

The price is shown at the top of this page. You pay online. After that you plan your fasting draw yourself.

If you want to buy a HOMA IR test, you do not need a referral. You share the result with your GP yourself afterwards.

Your result is usually in your account within a few working days. Every result carries a review by a BIG-registered doctor.

Want to broaden the picture? You can combine these markers later with a wider panel, such as the Whoop blood test.

Always discuss values outside the range with your GP. They can weigh what the result means for you.