What Is HOMA-IR? The Insulin Resistance Number, Explained
Labs · Insulin · Updated 2026-07-20
HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) estimates how hard your body is working to keep blood sugar normal. It is computed from two inexpensive fasting labs: HOMA-IR = fasting insulin (uIU/mL) x fasting glucose (mg/dL) / 405.
It matters for PCOS because insulin resistance is reported in well over half of people with the condition, including many at a normal weight - and it often shows up in HOMA-IR years before glucose or HbA1c look abnormal.
The formula, worked
Say your fasting insulin is 11 uIU/mL and fasting glucose is 92 mg/dL: 11 x 92 / 405 = 2.5. Same labs a year later at 8 and 88: 8 x 88 / 405 = 1.7. Two cheap numbers, one clear direction.
| HOMA-IR | Common interpretation |
|---|---|
| Below ~1.9 | Typically considered insulin sensitive |
| ~1.9 to 2.9 | Early or borderline insulin resistance |
| 2.9 and above | Significant insulin resistance for many labs |
Why PCOS care teams watch it
- Insulin resistance drives many PCOS symptoms, from cravings and energy crashes to irregular cycles.
- It responds to things you control - food pattern, movement, sleep, and medications your doctor may prescribe.
- Tracked over time, HOMA-IR shows whether what you are doing is working, long before weight or HbA1c move.
Your HOMA-IR, computed and tracked. PCOS Diet & Symptom Tracker calculates HOMA-IR from the fasting insulin and glucose you enter, shows it against reference bands, and charts every retest - so you and your doctor see the trend, not one number. Learn more about PCOS Diet & Symptom Tracker.
How to get the labs
Ask for fasting insulin and fasting glucose on your next draw - insulin is the one most often missing from standard panels, so request it explicitly. See the full PCOS blood test list for what else is commonly ordered. This article is educational and is not medical advice.
Frequently asked questions
What is a normal HOMA-IR?
Many labs consider values under about 1.9 insulin sensitive, but cutoffs vary by lab and population. Interpret yours with your clinician.
Can I have insulin resistance with normal glucose?
Yes - that is exactly what HOMA-IR is for. Insulin can be elevated for years while glucose stays normal, because the body compensates by producing more insulin.
How often should HOMA-IR be rechecked?
There is no fixed schedule; many clinicians re-test fasting labs every 3-12 months when tracking a change. Follow your doctor's plan.
Is HOMA-IR reliable for PCOS?
It is an estimate, not a gold-standard clamp test, but it is inexpensive, repeatable, and widely used to watch direction over time.