- Select the glucose unit (mg/dL or mmol/L). The calculator converts internally.
- Enter the fasting plasma glucose and fasting serum insulin — both must be from a true fasting sample (≥8 hours).
- Optionally enter fasting triglycerides (mg/dL) to compute the TyG index.
- Results (HOMA-IR, HOMA-β, QUICKI, TyG) appear instantly with interpretation and cut-off context.
- Note that cut-offs vary by population and assay — results are research/screening surrogates, not diagnostic of diabetes.
All computation runs in your browser; no values are stored or transmitted.
When to Use
Use these indices to screen for insulin resistance in adults with metabolic risk factors — obesity, prediabetes, polycystic ovary syndrome (PCOS), non-alcoholic fatty liver disease (NAFLD), metabolic syndrome, or CKD — when a formal hyperinsulinemic euglycemic clamp is not feasible. They are also used in research and clinical epidemiology to stratify cardiometabolic risk and monitor response to lifestyle or pharmacological interventions.
Appropriate use
Fasting adult patients with concurrent fasting glucose and fasting insulin on the same sample. HOMA-IR and QUICKI are most validated in non-diabetic populations. The TyG index is a useful surrogate in settings where insulin assays are unavailable, correlating well with insulin resistance across diverse populations including those with CKD.
Limitations
These are surrogate measures — not equivalent to the gold-standard hyperinsulinemic euglycemic clamp. HOMA-IR is less reliable in patients already on insulin or sulfonylureas, in severe hepatic dysfunction, or in type 1 diabetes. Insulin assay calibration and inter-laboratory variability can shift absolute values; cut-offs must be interpreted in the context of the specific assay and population reference ranges used by the reporting laboratory.
Pearls & Pitfalls
HOMA-IR is the most widely used index
HOMA-IR >2.5–2.9 is the most commonly cited cut-off for likely insulin resistance, though this varies by population. A value >3.8 has been associated with metabolic syndrome in several Southeast Asian cohorts. Always compare to the reference range provided by your laboratory and population-specific studies.
HOMA-β reflects beta-cell reserve
HOMA-β estimates the relative percentage of pancreatic beta-cell function. Low HOMA-β (<50–60%) in the context of high glucose may indicate progressive beta-cell failure. It is unreliable in patients with fasting glucose <63 mg/dL (the denominator approaches zero) — the calculator will flag this.
Pitfalls
(1) Do not use in patients currently on exogenous insulin — HOMA-IR and QUICKI will be unreliable. (2) Insulin assay variability is high; values from different labs are not directly comparable without assay-specific reference ranges. (3) TyG index cut-offs (commonly 4.5–4.65) are population-dependent; higher values in Asian populations may indicate risk at a lower absolute value than in European populations. (4) These indices are not diagnostic of diabetes — use ADA/WHO glucose criteria for diagnosis.
Why Use It
Insulin resistance is the central defect in type 2 diabetes, metabolic syndrome, NAFLD, PCOS, and plays a significant role in CKD progression and cardiovascular risk. Detecting and quantifying insulin resistance allows earlier lifestyle intervention, guides medication choice (e.g., metformin, GLP-1 agonists, SGLT2 inhibitors — the latter with specific benefit in CKD), and monitors the efficacy of treatment. HOMA-IR is inexpensive to calculate (requires only fasting glucose and insulin), and the TyG index is even more accessible in resource-limited settings where insulin assays may not be routinely available.
Insulin-Resistance Surrogate Calculators
Four independent calculators — each works on its own inputs. The TyG index needs only fasting glucose and triglycerides (a routine lipid + glucose panel) — no fasting insulin required. HOMA-IR, HOMA-β, and QUICKI each need a fasting insulin level.
1 · HOMA-IR
Homeostatic model assessment of insulin resistance — needs fasting insulin.
2 · HOMA-β (β-cell function)
Estimates pancreatic β-cell function (%) — needs fasting insulin.
3 · QUICKI
Quantitative insulin-sensitivity check index — needs fasting insulin.
4 · TyG Index NO INSULIN NEEDED
Triglyceride–glucose index — an insulin-free surrogate from a routine fasting lipid + glucose panel.
⚕ HOMA-IR = glucose×insulin/405 · HOMA-β = 360×insulin/(glucose−63) · QUICKI = 1/(log₁₀ insulin + log₁₀ glucose) · TyG = ln(TG×glucose/2), all in mg/dL. Cut-offs vary by population and insulin assay — these are screening/research surrogates, not diagnostic of diabetes. Physician interpretation required.
Next Steps
Use the result to support — not replace — clinical judgment.
- A high HOMA-IR (≥2.5–2.9) with borderline fasting glucose warrants lifestyle counseling (dietary modification, regular aerobic exercise, weight reduction). Target ≥5–7% weight loss in overweight patients to meaningfully reduce HOMA-IR.
- Consider metformin in patients with prediabetes, high HOMA-IR, and metabolic risk factors — review ADA Standards of Care for updated thresholds.
- In CKD patients, assess SGLT2 inhibitor eligibility (eGFR ≥20) and GLP-1 receptor agonist suitability for combined cardiometabolic-renal protection.
- Repeat HOMA-IR 3–6 months after a structured lifestyle intervention or pharmacological change to assess response.
- If HOMA-β is very low (<40%) with hyperglycemia, consider screening for latent autoimmune diabetes in adults (LADA) with anti-GAD antibodies.
- For confirmed insulin resistance in the context of CKD, refer to the Diabetes & Kidneys guide for integrated management.
Evidence & References
Formulas
| Index | Formula (conventional units) |
|---|---|
| HOMA-IR | (Fasting glucose mg/dL × Fasting insulin µU/mL) / 405 SI equivalent: glucose mmol/L × insulin mU/L / 22.5 |
| HOMA-β (%) | (360 × insulin µU/mL) / (glucose mg/dL − 63) |
| QUICKI | 1 / (log₁₀(insulin µU/mL) + log₁₀(glucose mg/dL)) |
| TyG index | ln[ fasting TG (mg/dL) × fasting glucose (mg/dL) / 2 ] |
Interpretation cut-offs
| Index | Cut-off | Interpretation |
|---|---|---|
| HOMA-IR | <1.0 | Insulin sensitive |
| HOMA-IR | 1.0–2.4 | Average (population-dependent) |
| HOMA-IR | ≥2.5–2.9 | Insulin resistance likely |
| QUICKI | >0.357 | Normal insulin sensitivity |
| QUICKI | <0.339 | Insulin resistant |
| TyG | <4.5 | Lower insulin resistance risk |
| TyG | ≥4.5–4.65 | Elevated insulin resistance (population-dependent) |
Cut-offs are approximate and population-dependent. Asian populations (including Filipino) may have significant insulin resistance at lower BMI than European reference populations — clinician judgment is essential.
References
- Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–419.
- Katz A, Nambi SS, Mather K, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000;85(7):2402–2410.
- Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab Syndr Relat Disord. 2008;6(4):299–304.
