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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 cut-off this tool uses for South Asians (no Indian guideline sets one)
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). This tool flags IR from ≥2.4 for South Asians and ≥2.5 for Western users. No Indian guideline sets a HOMA-IR cut-off; Indian studies have reported 2.5 (urban adolescents) and 2.86 (southern Indian adults).
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 2021/2022

HOMA-IR SCORE
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METABOLIC NUTRITION COACHING

IR Reversal Programme

Personalised glycemic load plans, insulin-sensitising food patterns, micronutrient repletion, and ICMR-INDIAB phenotype management from our metabolic dietitians.

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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 (2025)Metabolic obesity in India: MONO phenotype. PMC12550443
NIN DGI (2024)Dietary Guidelines for Indians: NIN, Hyderabad
RSSDI (2022)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 screening cut-offs: published cut-offs vary with population and insulin assay, and no Indian guideline or ICMR-INDIAB analysis sets one. 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.

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