Homeostatic Model Assessment of Insulin Resistance (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.
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 pre-diabetes 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.
There are three leading root 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,
Charles Meakin MD, MS, MHA
Travis Christofferson MS
Meakin Metabolic Care Website
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Chronic Disease Prevention Program- Metabolic Optimization Protocol (MOP)
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Disclaimer: This information is not meant as direct medical advice. Readers should always review options with their local medical team. This is the sole opinion of Dr. Meakin based on a literature review at the time of the blog and may change as new evidence evolves.