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HOMA IR: A simple blood test to predict type 2 diabetes and heart health risk
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HOMA IR: A simple blood test to predict type 2 diabetes and heart health risk

HOMA IR is akin to regular blood tests and could help initiate early intervention and precautions to avert pre-diabetes and diabetes
HOMA IR is a simple blood test where you will have to give a blood sample before eating food. (Photo by Anantha Subramanyam K / Happiest Health)

Insulin resistance (IR) or inability of insulin to ensure glucose uptake by the cells and tissues resulting in excess glucose circulating in blood (hyperglycemia) has now emerged as key causative factor for an array of metabolic conditions, mainly hypertension, high sugar which leads to obesity, type 2 diabetes and other cardiovascular conditions. Early detection of diabetes along with lifestyle and medical intervention to effectively manage it has become imperative to avert a major diabetes driven health crisis in the upcoming future. India now has 101 million people diagnosed with diabetes (primarily insulin resistance induced) and another 136 million living with prediabetes. Ironically, there is a simple blood test HOMA IR, which could gauge your insulin resistance level and also analyse your risk of developing diabetes.

HOMA IR or Homeostatic Model Assessment for Insulin Resistance, is akin to regular blood tests and could actually help to initiate early intervention and precautions to avert pre-diabetes and diabetes later. Dr Aditya S Chowti, senior consultant, Internal Medicine, Fortis Cunningham, Bengaluru adds that sometimes those with normal blood sugar levels on a specific day could have higher glucose levels on other days and that is where HOMA IR test and insulin resistance value helps to assess the diabetes risk.

“Insulin resistance levels lead to elevated blood sugar levels which over the time can lead to prediabetes and diabetes. Insulin resistance is also associated with metabolic syndrome X high blood glucose, hypertension, high cholesterol and excess visceral abdominal fat,” adds Dr Chowti.

He also points out that although it is a very high predictor for diabetes, there is no hard and fast rule that high insulin resistance means the person has diabetes as further expert diagnosis would be required to ascertain it.

What is HOMA IR?

It is a simple blood test where you will have to give a blood sample before eating food, like you do for your fasting blood glucose test.

Dr Adarsh K S, consultant – Diabetes & Endocrinology, Manipal Hospital, Old Airport Road explains that HOMA (Homeostatic assessment model) is used to estimate insulin resistance and beta-cell function (insulin producing cells function) from fasting glucose and insulin or C-peptide concentrations (a substance that is created when insulin is produced and released into the body).

Dr Chowti, explains fasting blood glucose and insulin levels from the blood sample are used to calculate the HOMA IR score.

“Insulin resistance rises when a given concentration of insulin is associated with an insufficient glucose response,” explains Dr Chowti.

People with high HOMA IR value will have high insulin resistance and are at a higher risk of diabetes and metabolic conditions. Those with low HOMA IR value will have lower insulin resistance. Comparatively, they are at lower risk of developing these conditions.

“Though it is generally stated that a HOMA IR value less than 1 unit is optimal and anything higher indicates prediabetes and diabetes. The value has to be interpreted with the help of a medical expert,” Dr Chowti adds. He also says that certain factors like hormonal changes and body weight etc should be taken into account before coming to a conclusion on the HOMA IR value.

How insulin resistance affects the body

Insulin resistance is often associated with diabetes because insulin is a hormone which helps to push glucose metabolised from your food into the cells, tissues and muscles to be used as energy. In people with high insulin resistance though insulin is secreted from the pancreas, it fails to ensure the uptake of glucose from the blood by the cells. So, there is a high level of circulating insulin and glucose in the blood which is the classic symptom of Type 2 Diabetes.

“We do know that in type 2 diabetes the insulin is present, but it is resistant to the human body,” adds Dr Chowti.

According to a study published in the journal Physiological Reports insulin action impacts fatty acid, amino acid, and potassium uptake in muscle and fat tissues. If this system becomes disrupted, it gives rise to insulin resistance. This affects virtually every tissue in the body, but has a dominant effect on muscle, adipose, and liver tissues.

Multiple research have confirmed that insulin resistance as the main causative factor for metabolic syndrome commonly termed as Metabolic Syndrome X (for example hypertension inadvertently leading to cardiovascular complications).

“We do see this very commonly in people with risk factors such as obesity, sedentary or unhealthy lifestyles and habits like smoking or excessive alcohol consumption. These have been identified to be causing metabolic syndrome and high insulin resistance is a precipitating factor,” Dr Chowti says.

According to the research study published in Diabetes Care, journal from American Diabetes Association, the HOMA IR Test value is also an independent risk factor for assessing the risk of cardiovascular complications in people with type 2 diabetes.

Why is the HOMA IR test not popular?

 Dr Chowti says that when it comes to HOMA IR’s popularity it has got more to do with the lack of awareness among the general public and health care professionals alike.

“It is to be noted that it is a quiet and important assessment tool specially helpful in preventing major lifestyle diseases. It should be made a part of an assessment program when we are assessing people for lifestyle or metabolic diseases”, he says.

Dr Adarsh K S explains HOMA- IR is mainly used for research purposes and epidemiological studies. An article published in Diabetes Care journal concludes that the HOMA model has become a widely used clinical and epidemiological tool and, when used appropriately, it can yield valuable data. However, as with all models, the primary input data need to be robust, and the data need to be interpreted carefully.

Takeaways

  • HOMA IR test is done through a simple blood test to find out if a person has insulin resistance and might be susceptible to Type 2 diabetes
  • If the HOMA IR value is high it means the person has a high level of insulin resistance
  • Insulin resistance can be reduced by following a healthy diet and lifestyle which can also prevent other health complications

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