Insulin resistance (HOMA-IR)
HOMA-IR units
How poorly insulin clears glucose, often scored with HOMA-IR from fasting glucose and insulin. It sits between diet, sleep, and long-run metabolic risk.
HOMA-IR is a common observational score. Lifestyle trials can move it. Arrows from HOMA-IR straight to income or mate choice are almost always tangled with education, body mass, and health-care access.
Also called HOMA-IR, insulin.
Connected relationships
Randomized trial · Moderate
Aerobic exercise→Insulin resistance (HOMA-IR)
A rise in Aerobic exercise does not identify a change in Insulin resistance (HOMA-IR).
In 48 Glasgow adults, a 12-week pedometer program that added about 3,000 steps a day on five days a week did not change fasting insulin or glucose against a no-change walking control.
Randomized trial · Contested
Berberine→Insulin resistance (HOMA-IR)
Higher Berberine decreases Insulin resistance (HOMA-IR).
Perez-Rubio 2014 found that 500 mg of berberine three times a day for three months raised the Matsuda insulin-sensitivity index from 2.1 to 3.1 versus placebo in 24 people with metabolic syndrome. Zhang 2008 lowered glucose versus placebo in 116 people with type 2 diabetes; the clamp contrast missed.
Randomized trial · Contested
Chromium→Insulin resistance (HOMA-IR)
Higher Chromium decreases Insulin resistance (HOMA-IR).
Jamilian 2016 found that 200 micrograms of chromium picolinate a day for eight weeks moved HOMA-IR by -0.8 versus +0.9 on placebo in 64 women with polycystic ovary syndrome (P<0.001). Kim 2012 saw a similar direction in 25 overweight children. Jain 2013's picolinate arm did not.
Observational · Low
Prenatal famine exposure→Insulin resistance (HOMA-IR)
Higher Prenatal famine exposure increases Insulin resistance (HOMA-IR).
People exposed to the Dutch Hunger Winter in utero had higher 120-minute glucose at age 58, and a smaller IVGTT subsample showed worse glucose tolerance after mid-gestation famine. Nobody randomized a siege.
Randomized trial · Moderate
GLP-1 receptor agonist→Insulin resistance (HOMA-IR)
Higher GLP-1 receptor agonist decreases Insulin resistance (HOMA-IR).
In 1,879 people with type 2 diabetes, weekly tirzepatide cut HOMA2 insulin resistance by about 16 to 24 percent, more than weekly semaglutide 1 mg (Frias 2024). A clamp study found the same direction versus placebo (Heise 2022).
Randomized trial · Moderate
Green tea / EGCG→Insulin resistance (HOMA-IR)
A rise in Green tea / EGCG does not identify a change in Insulin resistance (HOMA-IR).
Brown 2009 found that 400 mg of EGCG twice a day for eight weeks did not change insulin sensitivity, insulin secretion, or glucose tolerance versus lactose in 88 overweight or obese men. Hsu 2011 and Fukino 2006 also found no between-group HOMA difference after a green-tea extract or powder.
Randomized trial · Contested
Inositol→Insulin resistance (HOMA-IR)
Higher Inositol decreases Insulin resistance (HOMA-IR).
Giordano 2011 found that 2 g of myo-inositol twice a day plus diet for six months lowered the HOMA insulin-resistance index versus diet plus placebo in 80 postmenopausal women with metabolic syndrome. D'Anna 2015 saw a smaller HOMA drop and less gestational diabetes in 220 obese pregnancies; that file was open-label.
Randomized trial · Contested
Magnesium supplementation→Insulin resistance (HOMA-IR)
Higher Magnesium supplementation moves Insulin resistance (HOMA-IR) only in some conditions. Read the mechanism.
Drenthen 2024 found that 15 mmol a day of oral magnesium for six weeks did not change clamp insulin sensitivity versus placebo in 14 adults with insulin-treated type 2 diabetes (M value 4.6 versus 4.4). An intensive-care loading dose then moved HOMA in stress hyperglycemia (Heidary 2021).
Randomized trial · Moderate
Mediterranean diet→Insulin resistance (HOMA-IR)
Higher Mediterranean diet decreases Insulin resistance (HOMA-IR).
In 418 older Spaniards free of diabetes, PREDIMED-Reus assigned a Mediterranean diet with free extra-virgin olive oil or mixed nuts against low-fat advice. After a median four years the pooled Mediterranean arms had about half the new type 2 diabetes (hazard ratio 0.48). The measure is diabetes incidence, not HOMA-IR.
Randomized trial · Moderate
Obstructive sleep apnea→Insulin resistance (HOMA-IR)
Higher Obstructive sleep apnea increases Insulin resistance (HOMA-IR).
In 80 adults with severe OSA and morbid obesity, 12 weeks of CPAP improved two-hour glucose versus conservative care. HOMA-IR did not change in that trial. Pooled CPAP trials later found a modest HOMA-IR drop versus sham or no machine.
Randomized trial · Moderate
Night / rotating shift work→Insulin resistance (HOMA-IR)
Higher Night / rotating shift work increases Insulin resistance (HOMA-IR).
Four assigned night shifts with a nine-hour sleep opportunity reduced clamp insulin sensitivity about 25 percent in healthy adults. Matched day-shift controls did not move.
Randomized trial · Moderate
Prolonged sitting→Insulin resistance (HOMA-IR)
Higher Prolonged sitting increases Insulin resistance (HOMA-IR).
In 24 adults with type 2 diabetes, an 8-hour day of unbroken sitting produced a higher postprandial insulin curve than the same day with 3-minute walking or simple resistance breaks every half hour.
Randomized trial · High confidence
Sleep duration and regularity→Insulin resistance (HOMA-IR)
Higher Sleep duration and regularity decreases Insulin resistance (HOMA-IR).
Experimental sleep restriction lowers insulin sensitivity. Spiegel, Leproult, and Van Cauter put eleven young men into sleep debt and watched glucose tolerance fall into a pre-diabetic range. Later randomized weeks, including clamp studies and a six-week trial in thirty-eight women, found the same direction.
Observational · Low
Cigarette smoking→Insulin resistance (HOMA-IR)
Higher Cigarette smoking increases Insulin resistance (HOMA-IR).
In Cho 2022, 4,043 Korean adults without diabetes who met both urine NNAL and cotinine smoker cutoffs had higher triglyceride-glucose odds than people who met neither (men 1.74, women 2.01 after age, BMI, drink, walk, income, and pack-years); Eliasson 1997's 17 quitters, against 23 who kept smoking, improved clamp insulin sensitivity in eight weeks despite modest weight gain.
Randomized trial · Moderate
Resistance training→Insulin resistance (HOMA-IR)
Higher Resistance training decreases Insulin resistance (HOMA-IR).
Waters 2022 randomized 160 older adults with obesity and found that resistance training during matched diet-induced weight loss of about 9 to 10 percent raised the OGTT insulin sensitivity index 39 percent; combination training raised it 86 percent.
Randomized trial · Moderate
Eating window (time-restricted eating)→Insulin resistance (HOMA-IR)
Higher Eating window (time-restricted eating) moves Insulin resistance (HOMA-IR) only in some conditions. Read the mechanism.
In eight men with prediabetes, a supervised 6-hour early eating window improved insulin sensitivity without weight loss; later RCTs show the effect depends on clock time and calories.
Randomized trial · Moderate
Ultra-processed food intake→Insulin resistance (HOMA-IR)
Higher Ultra-processed food intake increases Insulin resistance (HOMA-IR).
In Hall's ward trial and Hamano's Tokyo crossover, ultra-processed menus matched for presented calories raised ad-lib intake and weight; Chen's US cohorts associate the same food class with later type 2 diabetes, not with measured HOMA-IR.
Cases
Sources
- SR Gray et al. (2009). The effect of a 12 week walking intervention on markers of insulin resistance and systemic inflammation.
- KG Pérez-Rubio et al. (2014). Effect of berberine administration on metabolic syndrome, insulin sensitivity, and insulin secretion.
- Y Zhang et al. (2008). Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine.
- VV Ruiz-Herrera et al. (2023). Pilot study on the efficacy and safety of berberine in people with metabolic syndrome and human immunodeficiency virus infection.
- M Jamilian et al. (2016). Chromium Supplementation and the Effects on Metabolic Status in Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial.
- CW Kim et al. (2012). Effects of short-term chromium supplementation on insulin sensitivity and body composition in overweight children: randomized, double-blind, placebo-controlled study.
- SK Jain et al. (2013). Effect of chromium dinicocysteinate supplementation on circulating levels of insulin, TNF-α, oxidative stress, and insulin resistance in type 2 diabetic subjects: randomized, double-blind, placebo-controlled study.
- E Aghdassi et al. (2010). In patients with HIV-infection, chromium supplementation improves insulin resistance and other metabolic abnormalities: a randomized, double-blind, placebo controlled trial.
- RS Lucidi et al. (2006). Effect of chromium supplementation on insulin resistance and ovarian and menstrual cyclicity in women with polycystic ovary syndrome.
- SR de Rooij et al. (2006). Glucose tolerance at age 58 and the decline of glucose tolerance in comparison with age 50 in people prenatally exposed to the Dutch famine.
- SR de Rooij et al. (2006). Impaired insulin secretion after prenatal exposure to the Dutch famine.
- T Heise et al. (2022). Effects of subcutaneous tirzepatide versus placebo or semaglutide on pancreatic islet function and insulin sensitivity in adults with type 2 diabetes: a multicentre, randomised, double-blind, parallel-arm, phase 1 clinical trial.
- KJ Mather et al. (2024). Effects of Tirzepatide vs Semaglutide on β-Cell Function, Insulin Sensitivity, and Glucose Control During a Meal Test.