homa calculation is a good adjunct to a1c and glucose testing in folks with type 2 diabete prediabetes or risk of diabetes due to family history or obesity. i believe more endocrinologists and other clinicians caring for such patients will use the homa calculator more routinely in the future. not to diagnose diabetes but rather to gain insight into the relative contributions of beta cell dysfunction and insulin resistance in folks with elevated a1c. i suspect homa can be used to spot people at risk for diabetes sooner than current screening tests (fasting glucose or a1c) however the appropriateness of this test for screening and perhaps for diagosis would need to be studied scientifically. in the meantime i believe it is a useful clinical tool under the right circumstances. . pancreatic beta cell function can be roughly estimated by measuring fasting insulin and glucose simultaneously (ask your doctor for these blood tests) then using. [a] homa calculator to assess the estimated beta cell activity and insulin resistance. . homa stands for "homeostasis model assessment". the general concept is that the higher your insulin resistance (due to excess body fat genetics or other causes) the harder your beta cells need to work to produce enough insulin to keep the glucose levels normal. someone with lots of insulin resistance say twice as much (200%) of a normal healthy person will have to have lots of beta cell activity (150% or 200%) just to compensate. over many years of excess beta cell activity (over 100% activity) then in some individuals the beta cell activity will start to peter out as reflected by lower insulin levels (or inappropriately non-elevated insulin levels in the face of mildly elevated glucose) and the calculator will indicate there is only around 50% beta cell activity. the a1c doesn't start to go up into the prediabetic range (a1c 6. 0-6. 4) until the beta cell activity is around 60%-50%. beta cell activity in the 40% or less range is what we see in type 2 diabetes. if we measured insulin and glucose and used the homa calculator in seemingly normal patients with moderate-to-high risk of eventual type 2 diabetes--such as patients with parents or siblings with type 2 or in patients wiith obesity then we could probably clarify the diabetes risk even sooner. we would not have to wait until beta cell function is 60%. we could spot it when it is at 80% etc. and monitor it. i think this is a concept scientists should explore further as a potential component of a national diabetes prevention/reversal strategy. .
what is a homa calculation?