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Insulin resistance MD's avatar

Where is the prevention part of our healthcare system to address this issue?

Guillermou's avatar

The Homeostasis Model Assessment (HOMA) estimates the steady-state function of beta cells (%B) and insulin sensitivity (%S).

It is based, in part, on a liver-beta cell feedback loop. Elevated fasting glucose levels reflect a compensatory mechanism that maintains fasting insulin levels when there is reduced insulin secretory capacity, and fasting insulin levels were elevated in direct proportion to decreased insulin sensitivity.

In 2004, the HOMA Calculator was released (1). This provides quick and easy access to the HOMA2 model for researchers who wish to use model-derived estimates of %B and %S, rather than linear approximations.

DATA: Glucose and insulin (fasting, in molar units mmol/L)

HOMA-IR = glucosexinsulin / 22.5

HOMA-Beta = 20xinsulin / glucose - 3.5%

IR is insulin resistance, and %Beta is beta cell function. Insulin is administered in mU/L. Glucose and insulin are both measured during fasting.

Beta cell function is around 100%, and HOMA IR (or the insulin resistance index) is very close to 1. Values ​​greater than 1 represent an increased level of insulin resistance.

The authors have extensively tested HOMA and HOMA2 against other measures of insulin resistance (or its reciprocal, insulin sensitivity) and β cell function. (2)

The approximations above refer to HOMA and are crude model estimates close to normal glucose and insulin levels in humans. The actual calculated HOMA2 compartmental model is published and available as the Interactive Homeostatic Model Assessment 2 (iHOMA2).

(1) HOMA Calculator: sasl.unibas.ch/11calculators-HOMA.php

(2) Extension of the homeostasis assessment model for β-cell function and insulin resistance to enable clinical trial outcome modeling through interactive adjustment of physiology and treatment effects: iHOMA2. Diabetes Care www.ncbi.nlm.nih.gov/.../23564921

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