What Is HOMA-IR?

Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) is a simple way to estimate how resistant your body is to insulin using two routine lab results: fasting glucose and fasting insulin. Insulin resistance means your cells are less responsive to insulin’s signal, so your pancreas has to produce more insulin to keep blood sugar in range. Over time, that higher insulin demand is linked to weight gain around the midsection, fatigue after meals, elevated triglycerides, fatty liver, prediabetes, and type 2 diabetes.

How HOMA-IR Is Calculated

In Canada, labs report glucose in mmol/L. The formula most clinicians use is:HOMA-IR = (fasting insulin in µU/mL × fasting glucose in mmol/L) ÷ 22.5.If your glucose is reported in mg/dL, use 405 in the denominator instead of 22.5. Because HOMA-IR is a model—not a direct measurement—it gives an estimate rather than a diagnosis. Still, it is very useful for tracking trends over time within the same person.

What Counts as “High” HOMA-IR?

There is no single universal cutoff because populations differ by age, sex, ethnicity, and metabolic risk. Many studies flag values around 1.9–2.9 as suggestive of insulin resistance in adults, but interpretation should consider your overall picture: waist circumference, triglyceride/HDL ratio, blood pressure, A1C, ALT (a liver enzyme), and symptoms such as post-meal crashes or carb cravings. The most important use is to compare your number to your own prior values after treatment or lifestyle changes.

Why HOMA-IR Matters for Weight and Metabolic Health

Insulin is a storage hormone. When insulin levels remain elevated, it becomes harder to lose fat mass and easier to store energy as liver and visceral fat. Elevated HOMA-IR often travels with high triglycerides, low HDL, fatty liver, and rising fasting glucose. Improving insulin sensitivity usually improves energy, appetite signals, waist circumference, and labs—even before the scale changes much. This is why a comprehensive, physician-led approach to weight loss and metabolic health is so effective.

How to Lower HOMA-IR

A personalized plan typically includes nutrition, movement, sleep, stress support, and sometimes medication. Helpful strategies include protein-forward meals, plenty of non-starchy vegetables and fibre, minimizing ultra-processed snacks, and time-consistent eating windows. Resistance training two to three days per week improves muscle insulin sensitivity, while walking after meals blunts glucose spikes. Optimizing sleep and treating sleep apnea can significantly improve insulin resistance. Some patients benefit from medications such as GLP-1–based therapies, metformin, or others when appropriate after medical assessment. If you want a structured, physician-supervised plan, see our weight loss clinic in Kitchener for an assessment and guided program: True North Metabolic – Weight Loss Clinic.

When to Test and How Often

Ask your clinician to order fasting glucose and fasting insulin on the same morning. To make results comparable, test under similar conditions each time: same lab, early morning, no illness, and after a typical week of eating and activity. Many patients recheck every 8–12 weeks while making changes, then less frequently once stable. If you are on medications that influence glucose or insulin, timing and interpretation should be coordinated with your physician.

Limitations You Should Know

HOMA-IR is an estimate based on fasting values and does not capture what happens after meals. It can be distorted by acute illness, recent vigorous exercise, or medications. It also does not diagnose diabetes; for that, clinicians use A1C, fasting glucose thresholds, or an oral glucose tolerance test. In lean individuals with symptoms, normal HOMA-IR does not rule out other causes of fatigue, weight change, or hormonal issues. Your care team may pair HOMA-IR with triglyceride/HDL ratio, liver enzymes, waist measurements, and, when appropriate, a glucose tolerance test or continuous glucose monitoring.

What to Expect at a Physician-Led Clinic

You should receive a clear plan that fits your life and biology: targeted nutrition coaching, strength and cardio programming, sleep and stress strategies, and a discussion of medication pros and cons when indicated. The goal is to reduce insulin resistance safely and sustainably, not quick fixes. If you prefer a coordinated approach with structured follow-up and lab tracking, book with our Weight Loss & Metabolic Health program here: True North Metabolic – Weight Loss Clinic.

Key Takeaways

HOMA-IR helps quantify insulin resistance using simple fasting labs. It is most powerful when interpreted in context and tracked over time as you implement changes. With the right plan, HOMA-IR often improves alongside energy, cravings, and waist circumference. If you are ready to get a personalized roadmap, our physician team at True North Metabolic can help you turn the number into action.