A Teaspoon of Sugar?
The HOMA Test:
Could You Have Insulin Resistance with Normal Blood Sugar?
Your blood sugar may be normal, but your body could already be working harder than it should to keep it there.
This is one reason the HOMA test can be useful.
What is the HOMA test?
HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) uses two simple fasting blood tests:
Fasting glucose
Fasting insulin
These results are combined to estimate insulin resistance – how effectively your body responds to insulin.
When your cells become less sensitive to insulin, your pancreas may produce more insulin to keep your blood sugar normal. For a while, your glucose and HbA1c can remain within the normal range.
HOMA testing can provide an insight into what may be happening behind the scenes.
Why does this matter?
Insulin resistance is associated with an increased risk of conditions including:
Type 2 diabetes
Prediabetes
Fatty liver disease
PCOS
Metabolic syndrome
It is also more common in people carrying excess weight, particularly around the waist, or those with a strong family history of type 2 diabetes.
Identifying increased insulin resistance can provide an opportunity to look at lifestyle and metabolic risk before blood sugar becomes significantly abnormal.
What are the benefits?
🔎 Looks beyond blood sugar
HOMA-IR provides information about insulin as well as glucose.
⏱ May identify metabolic changes earlier
Insulin resistance can develop before glucose or HbA1c become abnormal.
📊 Helps build a fuller picture
Your result can be considered alongside your weight, blood pressure, cholesterol, HbA1c and other health markers.
📈 Can help monitor change
For some patients, repeat testing can provide additional information when making sustained lifestyle changes.
Can HOMA testing help with prevention?
Potentially, yes.
Identifying increased insulin resistance can provide an opportunity to look more closely at modifiable risk factors such as:
Weight
Abdominal fat
Diet
Physical activity
Sleep
Alcohol intake
Blood pressure
Cholesterol
Overall cardiovascular risk
For someone who is at increased risk of type 2 diabetes, this information can support a more proactive approach to metabolic health.
The aim is not simply to obtain a number. The value is in understanding what that number means in the context of your overall health and deciding whether any changes or further assessment are appropriate.
Is HOMA-IR a diagnostic test?
No. HOMA-IR is an estimate, not a definitive diagnosis of insulin resistance, and there is no single HOMA-IR value that is considered normal for everyone.
It should therefore be interpreted alongside your other results and individual circumstances.
Who might consider HOMA testing?
It may be particularly useful if you have:
Excess weight or increased waist circumference
Poor diet
Excess alcohol consumption
A family history of type 2 diabetes
Prediabetes or borderline blood glucose
PCOS
Fatty liver disease
Other features of metabolic syndrome
A simple fasting blood test
HOMA testing requires a fasting blood sample, usually after 8–12 hours without food. Your fasting glucose and insulin are measured and HOMA-IR is calculated from the results.
The bottom line
Normal blood sugar does not always tell the whole story.
HOMA testing provides additional information about insulin sensitivity and can help identify metabolic risk that may not yet be apparent from glucose or HbA1c alone.
At London Harley Street Practice, we can assess HOMA-IR alongside your wider metabolic health profile to help you better understand your current health and future risk. Or you can simply book in for a routine blood test to reassure yourself that you are not on the slippery slope to diabetes.
Interested in finding out more? Contact London Harley Street Practice to discuss whether HOMA testing is appropriate for you.
Written by Dr McCreesh and Dr Bachelani 19/09/2026