Who is this especially useful for?
- ✓People with elevated HOMA-IR wanting the complete picture
- ✓Those with family history of type 2 diabetes
- ✓Individuals monitoring pre-diabetes progression
- ✓Anyone tracking metabolic health over time
HOMA-B complements HOMA-IR to show both insulin resistance AND production capacity.
What is HOMA-B?
HOMA-B stands for Homeostatic Model Assessment of Beta Cell Function. It was developed alongside HOMA-IR in 1985 by Dr. David Matthews at Oxford University.
Your pancreatic beta cells are responsible for producing insulin. When blood sugar rises, they release insulin to help cells absorb glucose. HOMA-B estimates how much insulin your beta cells are producing relative to your blood glucose level.
The key insight: context matters. Low HOMA-B with normal glucose suggests declining beta cell function. High HOMA-B with normal glucose suggests your pancreas is overworking to compensate for resistance.
Example Calculation
10
Fasting Insulin (μU/mL)
5
Fasting Glucose (mmol/L)
133%
(20 × 10) ÷ (5.0 − 3.5) = 133% — This indicates the pancreas is working harder than normal.
Two Sides of the Same Coin
HOMA-IR measures how well your cells respond to insulin (higher = more resistant). HOMA-B measures how well your pancreas produces insulin (both too low AND too high can be problematic). Together they tell the complete metabolic story.
Uses the same fasting labs as HOMA-IR.
Why HOMA-B Matters
- Pancreas Health Window: Reveals how hard your beta cells are working to maintain normal blood sugar
- Early Warning System: High HOMA-B often indicates compensating for hidden insulin resistance
- Progression Tracking: Falling HOMA-B after being high signals beta cell exhaustion
- Same Labs as HOMA-IR: Uses identical fasting glucose and insulin — calculate both from one blood draw
Three Perspectives on HOMA-B
Different health paradigms interpret HOMA-B thresholds differently:
HOMA-B Interpretation by Paradigm
Standard Medical
Research Consensus
Metabolic Optimization
Standard Medical
Clinical guidelines. 60-200% considered normal range.
Low HOMA-B with elevated glucose may indicate need for insulin therapy.
Research Consensus
Epidemiological targets. Both HOMA-B and HOMA-IR should be optimal.
Target 80-120% with HOMA-IR < 1.0 for long-term metabolic health.
Metabolic Optimization
Low-carb/ketogenic context. Lower insulin production expected on low-carb.
> 150% indicates compensation; < 80% signals declining reserve.
How to Test
💡 Pro tip: Order both HOMA-IR and HOMA-B from one blood draw. Our calculator gives you both perspectives from the same input.
The Metabolic Trajectory
HOMA-B tells a story about where you are in the metabolic spectrum:
The Progression Pattern
In early insulin resistance, beta cells compensate by producing MORE insulin (high HOMA-B). Over time, if the demand continues, beta cells can "burn out," leading to declining function (low HOMA-B). This is the progression from insulin resistance to type 2 diabetes.
Interpreting Results in Context
HOMA-B is most meaningful when considered alongside HOMA-IR:
| HOMA-IR | HOMA-B | Status | Interpretation |
|---|---|---|---|
| Low | Normal (80-120%) | Excellent | Healthy metabolic state. Your goal. |
| High | High (>120%) | Early Warning | Insulin resistance with compensation. Time to act. |
| High | Normal/Low | Concerning | Resistance without adequate compensation. Beta cells declining. |
| Normal | Very High (>200%) | Hidden IR | Glucose looks normal only because pancreas is overworking. |
How to Improve Your HOMA-B Score
Action depends on whether HOMA-B is too high or too low:
If HOMA-B Is Too High (>120%)
Improve insulin sensitivity
Diet, exercise, weight loss
Reduce refined carbohydrates
Lower demand on beta cells
Add resistance training
Builds glucose-absorbing muscle
Monitor HOMA-IR
Address the root cause
If HOMA-B Is Too Low (below 80%)
Medical consultation
Discuss with your doctor
Frequent glucose monitoring
Track trends closely
Aggressive lifestyle intervention
If not yet diabetic
Consider OGTT
For more diagnostic information
For Everyone
Quality sleep
7-9 hours, consistent timing
Stress management
Chronic stress affects insulin
Regular monitoring
Track both HOMA-B and HOMA-IR
Can Beta Cell Function Improve?
Yes, especially in earlier stages. Research shows that aggressive lifestyle intervention (low-carb diets, weight loss, exercise) can restore beta cell function in many people with pre-diabetes or early type 2 diabetes. The key is acting before significant beta cell loss occurs.
Frequently Asked Questions
Key Takeaways
- 1HOMA-B = (20 × Insulin) ÷ (Glucose − 3.5) — measures beta cell function
- 2Optimal HOMA-B is 80-120%; both too high AND too low are concerns
- 3High HOMA-B often indicates compensating for insulin resistance (early stage)
- 4Low HOMA-B suggests declining beta cell function (later stage)
- 5**Use HOMA-B alongside HOMA-IR** for the complete metabolic picture
- 6Early intervention can preserve and even restore beta cell function