Do We Know What Homeostasis Model Assessment Measures?

Estimating insulin sensitivity and beta cell function: perspectives from the modern pandemics of obesity and type 2 diabetes

“…It is a privilege to reflect on the impact of this landmark publication ('Then'), and to place it in the context of the challenges of present day diabetes research and clinical care ('Now'). The paper by Matthews et al and the topic of HOMA in general have been extensively reviewed and discussed by experts in the field over the years [5][6][7][8][9], including Matthews and his colleagues [10], and it is not our purpose here to provide yet another critique or systematic review of HOMA. Instead we will consider the impact of this classic paper in the context of the overlapping modern 'eras' in diabetes research and care that have provided the backdrop to this scientific study (Fig.…”

“…Despite limitations that have been the subject of previous reviews [5][6][7][8][9], HOMA has endured owing to its solid foundations in physiology. In the original study [4], fasting insulin concentrations were measured from three samples over 10 min, thereby taking account of the pulsatility of insulin secretion.…”

“…HOMA was originally devised as a simple mathematical algorithm for quantification of the relative contributions of insulin resistance and beta cell dysfunction to an individual's fasting hyperglycaemia. Given certain limitations [5][6][7][8][9], and despite the relatively small number of individuals studied to derive the 1985 model, HOMA has been widely accepted as a convenient surrogate marker of insulin resistance and beta cell function. To summarise expert critique, HOMA-IR has been well validated against the clamp technique and reflects hepatic more than peripheral insulin resistance, whereas HOMA-%B has been less rigorously evaluated, and is a much less robust estimate of beta cell function [5][6][7][8][9]20].…”

Response to Comment on Boyko and Jensen. Do We Know What Homeostatis Model Assessment Measures? If Not, Does It Matter? Diabetes Care 2007;30:2725–2728

“…Rivas-Crespo does take issue with the value of the constant in the reformulation that we presented in 2007 (2). We agree that the value of this constant does depend on the units of measurement used for both the HOMA and QUICKI equations and that the formula we presented is appropriate when glucose is measured in mmol/L and insulin is measured as mU/mL.…”

Comment on Boyko and Jensen. Do We Know What Homeostatis Model Assessment Measures? If Not, Does It Matter? Diabetes Care 2007;30:2725–2728

“…The formula for QUICKI is QUICKI 5 1=logðglucoseÞ1logðinsulinÞ (1) It can also be expressed by its inverse 1=QUICKI 5 logðglucoseÞ1logðinsulinÞ (2) In both formulas, glucose is expressed in mg/dL and insulin in mU/mL; log() is the common logarithm. Clearing the QUICKI value, we find QUICKI 5 1=½logðHOMA-IRÞ 1 2:61 (7) It seems clear that the direct calculation of each one of the mentioned indices is easier and more accurate than the somewhat imprecise Eqs.…”