Homeostatic Model Assessment of Insulin Resitance (HOMA-IR)

Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) can give a very early signal that your metabolism is becoming less efficient. It detects insulin resistance, a condition that is a causative factor in almost every chronic illness.  Maintaining insulin sensitivity (the opposite of insulin resistance) optimizes cellular metabolism promoting critical cellular pathways like DNA repair, autophagy, and immune function. The good news is that insulin resistance is easily detectable and highly reversible when caught early. Our MOP, C-MOP, and MD-Predict Panel programs include HOMA-IR.

HOMA IR may be one of the most revealing laboratory tests to measure one’s overall metabolic health. HOMA IR tells you how much insulin your body needs to produce to keep your blood glucose levels in check. In short, HOMA-IR detects a condition called insulin resistance.

Plagues of Prosperity

Modern lifestyles, including processed foods and low activity levels, can lead to insulin resistance. When blood glucose levels rise, insulin is released, signaling the cells to absorb blood glucose. Over time, cells can become “resistant” to insulin’s signal. The body then has to release more insulin to check blood glucose levels. The end stage of insulin resistance is type 2 diabetes when the cells fail to respond to insulin.

How common is insulin resistance? Very. Over half of the U.S. population has prediabetes or type 2 diabetes, and according to a recent study, only 12% of the U.S. adult population is considered “metabolically healthy.” Worse, another recent study determined that 40% of young Americans (18-44) have insulin resistance.

What are the consequences of insulin resistance? Because insulin resistance affects the core cellular energy generation process, its effects include many disorders. As determined by HOMA IR, increasing insulin resistance is strongly correlated to life expectancy.

A study that tracked 5,511 participants for 8.5 years illuminates the consequences of increasing HOMA IR on life expectancy.

Insulin Resistance Predicts Mortality in Nondiabetic Individuals in the U.S., 2010

*Our analytical cohort of 5,511 participants with a follow-up of 8.5 years

Adjusted for age, sex, BMI, waist-to-hip ratio, race/ethnicity, smoking, alcohol consumption, physical activity, education, systolic blood pressure, diastolic blood pressure, total serum cholesterol, serum HDL cholesterol, serum triglycerides, and serum C-reactive protein

Ausk KJ, Boyko EJ, Ioannou GN. Insulin resistance predicts mortality in nondiabetic individuals in the U.S. Diabetes Care. 2010 Jun;33(6):1179-85. doi: 10.2337/dc09-2110. Epub 2010 Mar 3. PMID: 20200308; PMCID: PMC2875420.

Why HOMA IR is So Important

Given that most Americans have some degree of insulin resistance and insulin resistance is strongly correlated to life expectancy, you can see why HOMA-IR is one of the most critical yet underused laboratory tests in the preventive health care setting. HOMA-IR can detect insulin resistance decades before it reaches the end stages of prediabetes and type 2 diabetes.

Here’s the rub: one of the most pressing problems in preventive healthcare today is how type 2 diabetes is characterized and diagnosed. Traditionally, type 2 diabetes is a disease formally described as elevated blood glucose and interpreted by a fasting blood glucose level of 126 mg/dl or higher or a hemoglobin A1C of 6.5% or higher. At Meakin Metabolic Care, we consider elevated insulin to characterize diabetes better.

This perspective change allows us to identify insulin resistance much earlier before problems surface and when it is much easier to reverse.

The Three Root Causes of Insulin Resistance

There are three leading causes of insulin resistance:

  • Inflammation
  • Stress
  • High level of insulin

When the primary stress hormone, cortisol, is incubated with cells in a petri dish, the cells rapidly become insulin resistant. The same is true for inflammatory cytokines. The third root cause of insulin resistance is insulin itself. Increasing insulin levels create a self-perpetuating cycle of increasing insulin resistance over time. At Meakin Metabolic Care, we address all three causes of insulin resistance and seek out “root causes” to prevent future problems.   HOMA-IR is paid for and incorporated into all the programs at MMC, along with Pheno-Age and many more (MOP, C-MOP, MD Consult, and Predict Panel).

Stay Strong and Curious,

Chuck and Travis