Calculate Your Insulin Resistance & Sensitivity With Homa

ACH85ACH85 ✭✭

For this experiment, you will require:


 


1. Your fasting glucose in mg/dl or mmol/l (standard labs)


2. Your fasting insulin in mIU/l (WellnessFX, others)


 


Using a model called HOMA2, you can calculate your insulin resistance as a percentage of the average metabolically healthy <35 population. Average is expressed as 1.00 . It's not perfect, but it correlates to other more accurate ways of determining insulin resistance really well (r=.88). More details on Wikipedia, as well as glucose mmol/l model. 


 


When glucose is expressed in mg/dl:


 


HOMA-IR = (Glucose x Insulin) / 405


 


(when glucose is expressed in mmol/L, divide by 22.5 instead of 405)


 


On my last labs, my glucose was 83mg/dL and my insulin was < 2 (the test doesn't count below 2, and it was below) 


 


Therefore, my HOMA-IR is expressed as < 0.41. In other words, my insulin resistance is lower than 41% of the average healthy person under 35's insulin resistance. 


 


Using this incredibly confusing calculator that breaks Chrome, Safari, and Opera (I had to download it and run it on my desktop) I was also able to calculate the same number, but expressed as insulin sensitivity. I'm 365% sensitive compared to the average.


 


 


Credits:


 


HOMA has been mentioned on the forum here, but no one followed up and there's been no other discussions I could find that mentioned "calculate insulin." 


 


I learned about this last night in an excellent article on cardio biomarkers on low-carb diets by Peter Attia. 


 


 


Questions for the Geeks:


 


1. Peter Attia says "ideally, [HOMA-IR] is 1.00" but then brags about his is < 0.48 (except mine is lower, eat it Peter.) Do we think his first statement was a mistake, and that lower is always better? Are there any downsides to having high insulin sensitivity?


 


2. The HOMA model also expresses pancreas beta cell function. Does anyone understand that?


 


3. Finally, for the truly geeky, the HOMA calculator I linked above (once you get it working) displays all kinds of cool (I think) graphs that I don't understand. It gives me a graph of glucose uptake in the brain, gut, liver, periphery, kidneys, and pancreas. It also claims to model personal blood sugar changes depending on "drug effects or phenotypes or pathology," (!!!) but I don't really understand this stuff. So if you want to really geek out, be my guest. In the attached files, you can compare my liver glucose uptake/efflux to my brain glucose uptake.


Comments

  • ACH85:


     


    Thank you for the info.


     


    This is what I came up with . . . 


     


    Fasting Glucose = 95


    Fasting Insulin = 3.0


     


    HOMR-IR = (95 x 3) / 405 = 0.7037


     


    I don't know what this number means.  Is a value of 1.0 ideal? Or is a value of less than one better? I will go read the Peter Attia article.

  • Found this . . .


     


    Healthy Range: 1.0 (0.5–1.4)


    Less than 1.0 means you are insulin-sensitive which is optimal.
    Above 1.9 indicates early insulin resistance.
    Above 2.9 indicates significant insulin resistance.


     


    http://www.thebloodcode.com/homa-ir-calculator/




  • HOMR-IR = (95 x 3) / 405 = 0.7037


     


    I don't know what this number means.  Is a value of 1.0 ideal? Or is a value of less than one better? I will go read the Peter Attia article.




     


    Nice numbers. Your data is looking good, and is to be expected from someone following the BP diet reasonably closely. 


     


    But yeah, it's a confusing metric... 1.0 is "the average insulin resistance of a metabolically healthy 35 year old." So your .7037 could be described as "70% the insulin resistance of the average metabolically healthy 35 year old." But that's confusing, since 70% of a 100% sounds bad, but really insulin resistance is bad, and you want to be lower than 100%... using the incredibly confusing calculator I also linked to, you can find your insulin sensitivity expressed as a positive, >100% metric. Since I already downloaded it, I ran your numbers, you are 243% as insulin sensitive as the 35 year old average. 


     


    Thanks for posting the healthy ranges. I prefer to focus on the raw data, but since this is a confusing metric, it's nice to have a cheat sheet here for future readers.


     


    The stats geek in me wonders if their healthy ranges were based on actual metabolic effects of each range, or just population-wide standard deviations from the mean... 

  • pieholepiehole
    edited October 2014

    You show no insulin resistance if your Blood Code reveals:


     


       * Fasting glucose is between 75–95 mg/dL (4.2–5.3 mmol/L).


       * TG:HDL ratio is near 1.0, +/- 0.5.


       * Fasting insulin is between 3–8 uIU/mL (18–48 pmol/L).


       * HgbA1C level is less than 5.6% (<37 mmol/mol).


       * Glucose/insulin as HOMA-IR is near 1 (.5–1.5).


       * Your total body fat is <28% for men and <32% for women.


     


    You show slight insulin resistance if you have two or more of the following:


     


       * Fasting glucose is greater than 95 mg/dL (5.3 mmol/L).


       * TG:HDL ratio is greater than 2.


       * Fasting insulin is greater than 8 uIU/mL (>48 pmol/L).


       * HgbA1C level is greater than 5.5% (>36 mmol/mol).


       * HOMA-IR is greater than 1.5.


       * The skin fold at your hip is greater than that at your triceps (by at least 5 mm).


     


    You show moderate insulin resistance if you have three or more of the following:


     


       * Fasting glucose is greater than 100 mg/dL (>5.6 mmol/L).


       * TG:HDL ratio is 3 or greater.


       * Fasting insulin is greater than 10 uIU/mL (>60 pmol/L).


       * HgbA1C level is greater than 5.7% (>39 mmol/mol).


       * HOMA-IR is greater than 2.5.


       * The skin fold at your hip measures near twice that at your triceps.


     


    You show severe insulin resistance if you have three or more of the following:


     


       * Fasting glucose is greater than 110 mg/dL (>6.1 mmol/L). Greater than 125 mg/dL (>7.0 mmol/L) is diabetes.*


       * TG:HDL ratio is greater than 4.


       * Fasting insulin is greater than 12 uIU/mL (>72 pmol/L).


       * HgbA1C level is greater than 6.0% (>42 mmol/mol). Greater than 6.4% (>46 mmol/mol) is diagnostic of diabetes.*


       * HOMA-IR is greater than 3.


       * The skin fold at your hip measures over twice that at your triceps.


     


    * If you have a diagnosis of type 2 diabetes, it also means that you currently express severe insulin resistance.


     


    Insulin Resistance: What It Really Means for You


    Over 40 percent of Americans are currently insulin-resistant, and the majority will develop type 2 diabetes in their lifetime given the current trends in diet and lifestyle. Insulin resistance is a practical human characteristic rather than a disease. Even natural medicine and functional medicine advocates wrongly blame insulin resistance for hypertension, elevated lipids, fatty liver, weight gain, and diabetes.


     


    Genetics research confirms that insulin resistance is an advantage.


    Your body is designed to survive periods with few calories and great physical effort. As of early 2013, at least 15 of your 23 genes are known to carry traits related to insulin resistance, and over 30 gene locations have been confirmed to raise susceptibility to insulin resistance and higher blood sugars. This is no mistake!


  • Great resources here thanks a million you two! My fiancee is trig:HDL is .68 and her HOMA shows over 100% beta cell function and sensitivity with an IR of .537. She eats a half of stick of butter a day.


  • My results today:


     


    * Fasting glucose is 96 mg/dL

    * TG:HDL ratio is 0.92

    * Fasting insulin is 6.328 uIU/mL

    * HgbA1C level is 5.5% (36.6 mmol/mol)

    * Glucose/insulin as HOMA-IR is 1.5.

    * Total body fat is 22.1% (men)


     


    I am 35 years old, 2 years on the Bulletproof diet, and these results doesn't seem too good. I mean - they are not too bad, but dangerously close to having some insulin resistance. And I am following the diet, not just to be "not bad", but to be totally optimal and perfect. 


     


    Now what do I do with this knowledge?


  • ACH85ACH85 ✭✭


    My results today:


     


    * Fasting glucose is 96 mg/dL

    * TG:HDL ratio is 0.92

    * Fasting insulin is 6.328 uIU/mL

    * HgbA1C level is 5.5% (36.6 mmol/mol)

    * Glucose/insulin as HOMA-IR is 1.5.

    * Total body fat is 22.1% (men)


     


    I am 35 years old, 2 years on the Bulletproof diet, and these results doesn't seem too good. I mean - they are not too bad, but dangerously close to having some insulin resistance. And I am following the diet, not just to be "not bad", but to be totally optimal and perfect. 


     


    Now what do I do with this knowledge?




     


    Is uIU/mL (what you stated) the same as mIU/L (what I stated in the first post?) I think it works out to be the same, but not positive. 


     


    Also, as with any blood test, you took a snapshot. If you walked up a flight or two of stairs or something similar before the blood draw, you may have released some glycogen, bumping up your numbers. Even if you got a crappy night of sleep beforehand. 


     


    You could look into why the HOMA model specifically lists <35. Taking a data set that includes 35 year olds, you may be doing significantly better.


     


    Finally, FWIW, I was 28 at the time of the blood draw referenced above, and my HbA1c was 5.1%, not all that far off from yours, and WellnessFX lists <5.7% as healthy. HbA1c is still a "snapshot" of your HbA1c, but the metric itself is a measure of long-term blood glucose stability. So you're still good there, and there is a strong argument that that's a better metric than HOMA-IR. 


     


    Your TG:HDL looks great, better than mine. 


     


    So what to do with this data? Personally I'd say no major changes for now, maybe look into expected changes >35. 



  • Is uIU/mL (what you stated) the same as mIU/L (what I stated in the first post?) I think it works out to be the same, but not positive. 




     


    I'm certain its the same thing, because Âµ = 1/1000 m, and 1 mL = 1/000 L


    Source: http://en.wikipedia.org/wiki/Metric_prefix#List_of_SI_prefixes


     


    But anyway, I was doing some bulking 1 month ago (4000 kcal for 45 days, with over 80% calories from fat), to gain some mass, now I am going to try to cut the fat without losing muscle, maybe when I get to 10% body fat, the other numbers will improve too. I am just wondering how could my insulin be on the edge of resistance, if every day over 80% of my calories where from Kerrygold butter, and I are zero grains and sugar the last 2 years, only <100g carbs per day from root vegetables and sometimes a banana or two. And the last month I was about 2500 kcal, now doing 2200 kcal. Its supposedly not about calories, but still - I expected my numbers to be better. Or maybe that's just what you get when you are skinny-fat. You know, I weigh 72 kg (160 lb), but this 22% fat (from DEXA).

  • ACH85ACH85 ✭✭


    But anyway, I was doing some bulking 1 month ago (4000 kcal for 45 days, with over 80% calories from fat), to gain some mass, now I am going to try to cut the fat without losing muscle, maybe when I get to 10% body fat, the other numbers will improve too. I am just wondering how could my insulin be on the edge of resistance, if every day over 80% of my calories where from Kerrygold butter, and I are zero grains and sugar the last 2 years, only <100g carbs per day from root vegetables and sometimes a banana or two. And the last month I was about 2500 kcal, now doing 2200 kcal. Its supposedly not about calories, but still - I expected my numbers to be better. 




     


    My only thoughts here: It's not supposed to be about calories, but surely big changes in caloric consumption will have an effect on insulin handling. Also, while we tend to not pay attention to the claims around here, some people do claim that HFLC diets increase insulin resistance. I don't buy it, but it's something to consider. Also, if your intake is very similar day-to-day, perhaps your body might maintain a higher fasting BG or fasting insulin. At the time of my test, I was having large carb refeed days, was probably lower carb than you are on most days, but occasionally had sugary cheat days too. Essentially the armchair biologist logic here was that I was keeping my insulin and blood sugar regulation really guessing, so at the time of the test (a Friday, I think the 5th day of very clean eating) my blood sugar and insulin were extra low. IF that logic makes sense, then the opposite could also be true, that eating a similar macro breakdown every day would lead to stabler, perhaps more normal BG and insulin levels, which you seem to have. 

  • Jason MillerJason Miller Mother nature isn&#39;t stupid mod
    I'd say carb intolerance more than insulin resistance, we see people coming off low carb diets take a long road to recovery from things like bloating and water retention from pretty silly amounts of carbohydrate, the damage is repairable though, can take up to a year.
    My Crossfit auto template programming here, body composition coaching through Eat to Perform here,
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