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CLINICAL TOOL · HOMA-IR · ICMR-INDIAB-23 · ADA 2024 · NIN 2024 · RSSDI 2022 · ESPEN

Insulin Resistance
Score Calculator.

HOMA-IR with ethnic-specific thresholds, ICMR-INDIAB metabolic phenotype classification, glycemic load guidance, and micronutrient flags — calibrated for the Asian Indian phenotype and validated against global guidelines.

43.3%of Indians are MONO — normal BMI, hidden metabolic dysfunction (ICMR-INDIAB-23)
2.4HOMA-IR threshold for South Asian IR (RSSDI / ICMR-INDIAB consensus)
85–100Optimal daily glycemic load per 1000 kcal for IR reversal
HOMA-IR · Ethnic-Specific Thresholds · ICMR-INDIAB
MONO/MOO Phenotype · WHtR · Metabolic Obesity
Glycemic Load 85–100 Target · NIN 2024 Diet
Mg · Zn · Vit D · Chromium Flags · ADA CGM

Calculate Your HOMA-IR Score

HOMA-IR · Ethnic phenotype thresholds · ICMR-INDIAB metabolic classification · NIN 2024

Fasting glucose and insulin must be measured after 8–12 hours of fasting (no food, only water). Lab values are required for HOMA-IR calculation. Anthropometric values (waist, height) help classify the ICMR-INDIAB metabolic phenotype — critical in India where 43.3% have normal BMI but hidden metabolic dysfunction (MONO phenotype).
Ethnicity — Phenotypic Classification * CRITICAL: South Asian/Indian women exhibit the Asian Indian Phenotype — higher visceral adiposity at lower BMI, faster beta-cell exhaustion, 3x less insulin secretion vs Pima Indians (PMC6834872). HOMA-IR threshold shifts from ≥2.5 (Western) to ≥2.4 (South Asian) for maximum sensitivity and specificity (ICMR-INDIAB ROC analysis).
Fasting Laboratory Values * Values must be from a certified laboratory after 8–12 hours fasting. Glucose in mg/dL (auto-converts to mmol/L). Insulin in mIU/L (= µU/mL). Formula: HOMA-IR = (Glucose mmol/L × Insulin mIU/L) / 22.5. Source: Matthews DR et al. Diabetologia 1985;28(7):412-419.
Normal fasting: 70–99 mg/dL. Pre-diabetes: 100–125. Diabetes: ≥126.
Normal fasting: 2–25 mIU/L. Hyperinsulinaemia: >25 mIU/L (labs vary).
Anthropometrics * WHtR (Waist-to-Height Ratio) is the strongest predictor of IR (OR: 4.9, p<0.0001) — stronger than BMI alone. A WHtR ≥0.50 with normal BMI identifies the MONO phenotype (43.3% of India). Waist measured at umbilical level. Height in cm.
Measure at navel level, relaxed exhalation.
Additional Metabolic Markers (Optional) Used to calculate TyG index (surrogate IR marker), classify ICMR-INDIAB metabolic phenotype more accurately, and assess cardiovascular risk. Triglycerides and HDL are part of the ICMR-INDIAB metabolic dysfunction criteria.
Normal: <150 mg/dL. High: ≥200.
Low (IR risk): <40 men, <50 women.
Normal: <5.7%. Pre-DM: 5.7–6.4%. DM: ≥6.5%.
Normal: <120. Elevated: 120–129. Stage 1 HTN: 130–139.
Sex and Age Sex affects waist circumference thresholds for metabolic risk classification and HDL interpretation. Age modifies beta-cell senescence and IR progression context.
Micronutrient Lab Results (Optional) Deficiencies in these micronutrients directly impair insulin receptor kinase activity and beta-cell function. Vitamin D deficiency affects 40–70% of Indian adults. Zinc deficiency affects 50–70%. Both accelerate the Asian Indian beta-cell secretory defect. NIN 2024 flags and ESPEN clinical protocols are generated.
Deficient: <20. Insufficient: 20–29. Optimal: 30–60.
Alert threshold: <66 mcg/dL (NIN/ICMR). Normal: 66–120.
Deficiency: <1.8 mg/dL. Normal: 1.8–2.4.
Dietary Preference * Determines IR-specific Indian food substitutions and glycemic load guidance. Vegetarians rely more heavily on legumes and millets — the 3:1 cereal:pulse ICMR ratio is critical. Non-vegetarians: red meat is strongly discouraged (RSSDI 2024 — heme iron and amino acid profile drive intramuscular lipid deposition).

HOMA-IR: Matthews 1985 · ICMR-INDIAB-23 · NIN DGI 2024 · RSSDI 2022 · ADA 2024 · ESPEN 2023

HOMA-IR SCORE
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METABOLIC NUTRITION COACHING

IR Reversal Programme

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WHAT THIS CALCULATOR GIVES YOU

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HOMA-IR ScoreEthnic-specific thresholds — South Asian ≥2.4, Western ≥2.5
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ICMR-INDIAB PhenotypeMONO, MOO, MHNO, MHO classification with WHtR
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Glycemic Load GuidanceOptimal 85–100 GL/1000 kcal target · NIN 2024 food plan
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Micronutrient FlagsVitamin D, Zinc, Magnesium, Chromium — ESPEN protocols
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ADA CGM TargetsTIR, TBR, TAR goals — ADA Standards of Care 2024

CLINICAL REFERENCES

Matthews DR et al. (1985)HOMA model for IR. Diabetologia 28(7):412-419
ICMR-INDIAB-23 (2024)Metabolic obesity in India — MONO phenotype. PMC12550443
NIN DGI (2024)Dietary Guidelines for Indians — NIN, Hyderabad
RSSDI (2022/2024)Clinical Practice Recommendations — T2DM India
ADA Standards of Care (2024)Glycaemic targets and CGM metrics

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Medical Disclaimer: HOMA-IR is a validated surrogate marker (Matthews et al. 1985) — not a clinical gold standard. The gold standard for IR is the euglycaemic-hyperinsulinaemic clamp, which is invasive and unsuitable for routine practice. HOMA-IR thresholds used in this calculator (South Asian ≥2.4, Western ≥2.5) are drawn from ICMR-INDIAB ROC analyses and published literature. These are population-level estimates and individual interpretation requires clinical context. This tool does not diagnose insulin resistance, metabolic syndrome, diabetes, or any other condition. Lab values entered are for educational calculation only — not diagnostic. Always discuss results with a qualified endocrinologist, diabetologist, or registered dietitian. DietXP Limited accepts no clinical liability.