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Help interpreting HOMA-IR Test Result

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musterfox

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Hi all.
New here and would really appreciate your help and advice.

Firstly to clarify - I do not have Diabetes. I am male, 50 years of age and currently weigh 60Kgs.

4 months ago I had my blood sugar tested and discovered that my Glucose (Fasting) was 103 and my HbA1C (EDTA) was 5.2. As the normal Glucose Fasting range for non-diabetics is supposed to be between 74-99 I was concerned particularly as I have a very sweet tooth and eat sugar laden foods and deserts at least two to three times a day and have been doing so for decades.

I reduced my sugar craving intake to once a day and drastically cut my carbs while adding more proteins and healthy fats to my diet. My weight went down from 65kgs to 60kgs over the past 4 months.

I had my blood sugar tested 3 days ago and thankfully my Glucose (Fasting) is down to 85 and my HbA1C (EDTA) is down to 4.9.

However along with this test I also had another test done called HOMA-IR. I had this done as several "holistic doctors" on various Youtube channels mentioned this as a far better test for people who dont currently have Diabetes but wanted to check for potential diabetes down the line.

It tooks a couple of days to get the result and considering I have never done this test before I am confused about the results. My doc is out of town for a week so I cant get any info from him either.

Please see attatched iamge. There are 3 results on which I need clarification.

Firstly my "Insulin Serum, Fasting" is stated as 1.90 uU/mL whereas the reference range is stated to be 2.00 - 25.00.

The fact that this is marked in BOLD font indicates that this valus is out of reference range and therefore (I assume) a pontential problem?

What does this low level mean? Could I have some other type of Diabates eg. LADA/MODY or some other medical condition and if so what further tests need to be done?

The other two results I am confused about are -
Beta Cell Function (%B) 49.50 %
Insulin Sensitivity (%S) 263.00 %

There is no reference range mentioned for these results. So are these good/bad results and what do they indicate? What should be the "ideal" range for these values? Are my values okay or are theya potential problem?

Any advice sinceerely appreciated.
Kind regards
Muster
 

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Completely ok to score a very low HOMA-IR on a low-carb diet. Yes your fasting insulin is 'low', but this is to be expected in a metabolically healthy individual eating a diet that doesn't demand much insulin. For reference I scored a 0.3 in February, so in the same ballpark.

You have nothing to worry about with any of those figures.
 
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Hello Jim.

Firstly THANKS for the quick reply - greatly appreciated.

I actually just posted my question in another forum as well because I had not seen your reply.

Could you help with one more clarification?

I know you said I have nothing to worry about any of the figures but I would still like to know what the "normal" range for Beta Cell Function (%B) is supposted to be.

I searched high and low on the net and found several references to it but they seem to be highly techinal research studies that are beyond my limited comprehension.

What I would like to kniow is - does Beta Cell Function (%B) start at 100% for everyone and then detiorate with age (or other causes)?

If so, is there some sort of chart or table available online somewhere that one can cross reference to see how my values stack up to another male who is also 50 years old?

TBH the fact that mine has dropped less than HALF (I'm ASSUMING here that it starts at 100%) of what it should be ideally is somewhat worrying.

Lastly, do my above resutls mean that I can continue to eat a sugary treat everyday without much worry as long as I continue to monitor my blood glucose levels and stick with my low carb diet?

I did try various types of fruits as well as sugar substitutes (stevia etc.) instead of white/brown sugar based products but they just didnt work as well and I would continue to crave sugar. Once I eat my sugary treat (which I usually bake myself 90% of the time) then I feel great. Its like my brain wants/needs it. I know it sounds ludicrous but maybe this has someting to do with how sugar spikes Dopamine and I am used to that "sugar high"? I really dont know TBH but it is a very real problem for me unfortunately and not just a figment of my imagination.

Do let me know.

Thanks in advance...
Muster
 
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Cant help you there. I know nothing about that beta cell value. I suspect that it's a calculation rather than a measurement. Perhaps some type 1s will have more knowledge of this.
 
I had a HOMA-IR and my result was 0.8 (BG 83, insulin 4.1). That is supposedly insulin sensitive and the insulin is quite normal fasting.

I don’t know how beta cell function would be estimated from two static figures of fasting BG and fasting insulin.

Have you checked your blood sugar after your deserts or a high carb starchy food?

I see blood sugar spikes into the pre-diabetic range if I eat too many carbs at once. I need to limit carb portion size unless I will be exercising immediately after eating.

I would be more concerned about limiting BG spikes than I would be about a slightly elevated fasting glucose. The damage comes with frequent spikes over 140 or with a level continuously over 120.
 

Hello Sapien.

Thanks for replying.

Of late my pre-meal Insulin before lunch is usually between 85-95. One thing I completely forgot to mention is that I eat only two meals a day since the past 4 months. I skip breakfast completely and strictly follow Intermttent Fasting for 15+ hours (overnight till lunch the next day) with only water allowed during that period.

I have only ever tested my Insulin immediately before and 2 hours after a meal (dinner is the only meal when I have the dessert),

Usually my 2 hour post meal reading is +/- 5-10 units from my pre-meal value.

To clarify - I would say 70% of the time it is +5-10 units ABOVE my pre-meal value and 30% of the time its either right back to where I was pre-meal or sometimes even up to 1-5 units LOWER than my pre-meal value. I have no idea why it works that way but it does. I assume its the food/dessert in question that causes the varied values.

I have never tested insulin at say 45 minutes, 1 hour or 1 and a half hours post meal so I honestly dont know how it varies at those times. Do I need to test this? I was under the impression that a 2 hours post meal test was all that was reqd.?

Do advise.

Kind regards
Muster
 
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Hi Muster,

I think you mean you test glucose (rather than insulin) at 2 hr after eating.

My experience is that when eating carbs with little fat that the highest reading comes between 30 min and 1 hour. When eating a fatty meal the highest reading is usually lower but doesn’t come down as quickly and the reading at 2hrs can be a bit higher than at 1 hour.

I have tested a food like 2 cups of sweet potatoes. About 54 quickly digested carbs. I will see a blood sugar of about 150 at 1 hour and 105 at two hours. If I eat it with butter, the high will be around 135 and at two hours it will be about 115.

If I only tested at 2hours, I wouldn’t know that I spiked over 140. I would think everything was just fine. I try to stay under 120 at peak, so 2 cups of sweet potatoes is too much. I can eat 1/2 a cup without much effect.
 
Jim Lahey said:
Cant help you there. I know nothing about that beta cell value. I suspect that it's a calculation rather than a measurement. Perhaps some type 1s will have more knowledge of this.
Click to expand...

Hi Jim, not this one. I doubt very much whether anyone gets a specific test done for remaining beta cell function, I wish!!! Great topic though, I will await any replies with interest. x
 
This might be helpful:-

'HOMA apportions the basal state of insulin and glucose in terms of resistance and β-cell function. It can be seen from the model that for individuals with normal glucose levels, HOMA solutions might indicate 100% β-cell function and 100% insulin sensitivity, or, in the case of a thin, fit individual with high sensitivity, 50% β-cell function and 200% insulin sensitivity. Within the context of reporting both results, these are appropriate solutions—sensitivity is doubled, so the β-cells are functioning at 50% of normal. However, if the β-cell data are reported in isolation, one might conclude erroneously that the subject had failing β-cells, as opposed to appropriately low secretion, because the sensitivity of the body was high.' https://care.diabetesjournals.org/content/27/6/1487​
 
Sapien said:
Hi Muster,

I think you mean you test glucose (rather than insulin) at 2 hr after eating.

If I only tested at 2hours, I wouldn’t know that I spiked over 140. I would think everything was just fine.
Click to expand...

Hi Sapien
Sorry about that - I meant BG not insulin.

If the method you suggest is what one should ideally follow then I am embarassed to say that I have never tracked it that way.

My reason for doing it the way I mentioned is that whenever I had my BG tested professionally (meaning by a 3rd party lab and not a home BG testing device), it would be first thing in the morning after 6-8 hours of overnight fasting.

Someone would come over from the lab, take a sample, ask me to eat breakfast (which I did under these circumstances) and return approx 2 hours later to take another sample.

Its only these two values (Fasting & PP) that my doctor ever asked for apart from an occasional HbA1c score once every 3-6 months.

In your method, how do you cater for eating different types of foods and various combos (eating Food A with B at one meal followed by A with D another and E with F on another and so on pretty much endlessly? Also, what if you eating out? Do you carry a meter and strips with you to track your values just in case you eat a "new" combo of items you havent tested before? Curious to know.

Even IF I kept a food log I think it would be very, very hard for me do that level of tracking - and thats apart from having to poke myself so many times a day to get various readings. Ouch!

Does this also mean that Doctors are actually missing many cases of Diabetes (or Pre-Diabetes to be more precise) simply because they only ask for Fasting/PP and the occasional HbA1c?

Do advise.

Kind regards
Muster
 

Hello Dark Horse.

THANK YOU!!!!

That is really helpful and clears all my doubts in simple English rather than the gobbledygook I came across in various Research Studies and Docs I found on HOMA-IR testing.

Sincerely appreciate your finding this!

I hope you dont mind me quoting the info you came across in another Diabetes forum where I also asked the same question.

Kind regards
Muster
 
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It is good that your doctor had a 2-hour post prandial test done along with fasting glucose. That is a real world result.

The standard OGTT has a sample taken fasting, at one hour and another a two hours. If any reading is abnormal, it signifies impaired glucose metabolism.

My readings tend to be good at two hours, but frequently are a bit high at one hour. I seem to have a delayed insulin response. As such, I personally test at one hour more often than at two hours.

I test multiple times to see how different foods effect me. But then I generally don’t test after those meals once I know the effect it will have on me.

My point was simply to say that one should check to see if one spikes and not just rely one fasting or two hour readings - if you really want to know how your body is reacting to different types of foods.

Everyone is different. Many say that they can’t eat any bread. I can eat a whole grain and seed bread and see only a mild rise in glucose, but if I eat a big white bread hamburger bun my blood sugar temporarily spikes too high. I don’t eat hamburger sandwiches anymore, not that I at many in the past, but knowing the effect white bread has on me, I simply avoid it in any form. I still eat real whole grain bread in moderation.

I have more or less learned what I can eat to always keep my blood sugar below 120 mg/dL at peak.

I haven’t carried a meter to test after eating out. I would like to wear an CGM for a while to get a better idea of how my BG levels change throughout the day. Getting a prescription for one isn’t easy.
 
Sapien said:
I haven’t carried a meter to test after eating out. I would like to wear an CGM for a while to get a better idea of how my BG levels change throughout the day. Getting a prescription for one isn’t easy.
Click to expand...
Type 1’s can struggle. Type 2 or prediabetes dont really have a hope at present for a cgm on the nhs.
 
HSSS said:
Type 1’s can struggle. Type 2 or prediabetes dont really have a hope at present for a cgm on the nhs.
Click to expand...

I would go so far as to suggest most type 1s don't have much of a hope either. The criteria is brutal.
 
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