HOMA-B Explained
Understanding your pancreas — measure how well your beta cells produce insulin and catch early warning signs.
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.
Most discussions of metabolic health focus on insulin resistance — how well your cells respond to insulin. But there's another equally important question: how well is your pancreas producing insulin in the first place?
That's what HOMA-B measures. HOMA-B (Homeostatic Model Assessment of Beta Cell Function) estimates how effectively your pancreatic beta cells are producing insulin. It's the complement to HOMA-IR, and together they tell a more complete metabolic story.
Where to find your Glucose and Insulin values
Insulin isn't always included — ask your doctor to add it to your panel
Two Sides of the Same Coin
HOMA-IR
Insulin Resistance
- •How well your cells respond to insulin
- •Higher = more resistant
- •Target: < 1.0 optimal
HOMA-B
Beta Cell Function
- •How well your pancreas produces insulin
- •Both too low AND too high can be problematic
- •Target: 80-120% optimal
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.
The Formula
HOMA-B = (20 × Insulin) ÷ (Glucose − 3.5)
Glucose in mmol/L, Insulin in μU/mL • Result expressed as percentage • Our calculator handles all conversions
Example Calculation
Glucose: 5.0 mmol/L (90 mg/dL)
Insulin: 8 μU/mL
(20 × 8) ÷ (5.0 − 3.5) = 106%
Normal Function
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.
1985
Developed
Oxford University HOMA model
Matthews et al.
80-120%
Optimal Range
Normal, healthy beta cell function
Clinical standard
50%
Decline at T2D
Beta cells ~50% depleted at diagnosis
UKPDS study
What Research Shows
The UK Prospective Diabetes Study (UKPDS) found that by the time type 2 diabetes is diagnosed, approximately 50% of beta cell function has already been lost. This highlights why early detection and intervention is crucial — HOMA-B can detect declining function years before glucose abnormalities appear.
5,100+ participants in UKPDS longitudinal study
How Different Paradigms Interpret HOMA-B
Different medical approaches interpret HOMA-B values through different lenses:
Standard Medical View
Thresholds: 80-120% normal, < 50% or > 200% warrant investigation
HOMA-B helps assess beta cell reserve in diabetes management. Used alongside HbA1c and glucose monitoring.
Low HOMA-B with elevated glucose may indicate need for insulin therapy.
Research Consensus View
Thresholds: Target 80-120% with HOMA-IR < 1.0 for optimal metabolic health
Both metrics should be optimal for long-term health. High HOMA-B without high HOMA-IR is a concern.
Optimize through lifestyle to maintain beta cell health for decades.
Metabolic Focus View
Thresholds: > 150% indicates compensation, < 80% signals declining reserve
High HOMA-B is an early warning of insulin resistance. Falling HOMA-B after being high signals beta cell exhaustion.
Carbohydrate restriction can rapidly reduce the demand on beta cells.
What's a Good HOMA-B Score?
| HOMA-B | Category | What It Means |
|---|---|---|
| < 50% | Low | Significantly reduced beta cell function. May indicate advanced metabolic dysfunction or beta cell exhaustion. |
| 50 – 80% | Borderline Low | Reduced beta cell function. Early warning sign that deserves attention. |
| 80 – 120% | Optimal | Normal, healthy beta cell function. Pancreas is working efficiently. |
| 120 – 200% | Compensating | Beta cells producing extra insulin. Often indicates underlying insulin resistance. |
| > 200% | Overworking | Beta cells significantly overworking. High demand from severe insulin resistance. |
The Metabolic Trajectory
HOMA-B tells a story about where you are in the metabolic spectrum:
Insulin-sensitive cells, efficient pancreas. Goal state.
Cells becoming resistant, pancreas compensating. Still reversible.
Severe resistance, pancreas working overtime. Intervention needed.
Pancreas starting to fail. Blood sugar rises. Pre-diabetes threshold.
Insufficient insulin production. Type 2 diabetes territory.
The good news: Stages 1-3 are typically reversible with lifestyle intervention. Even Stage 4 can often be improved.
Interpreting Results in Context
HOMA-B is most meaningful when considered alongside HOMA-IR:
Low HOMA-IR + Normal HOMA-B
Excellent
Healthy metabolic state. Your goal.
High HOMA-IR + High HOMA-B
Early Warning
Insulin resistance with compensation. Time to act.
High HOMA-IR + Normal/Low HOMA-B
Concerning
Resistance without adequate compensation. Beta cells may be declining.
Normal HOMA-IR + Very High HOMA-B
Hidden IR
Glucose looks normal only because pancreas is overworking.
What To Do About Abnormal HOMA-B
Action depends on whether HOMA-B is too high or too low:
If HOMA-B Is Too High (>120%)
Beta cells are compensating for insulin resistance:
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 (<80%)
Beta cell function is declining — more serious:
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
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.
Key Takeaways
- 1HOMA-B measures beta cell function — how well your pancreas produces insulin
- 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)
- 5Use HOMA-B alongside HOMA-IR for the full metabolic picture
- 6Early intervention can preserve and even restore beta cell function
References
- Matthews DR, et al (1985). Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia, 28(7), 412-419. PMID: 3899825
- Wallace TM, Levy JC, Matthews DR (2004). Use and abuse of HOMA modeling. Diabetes Care, 27(6), 1487-1495. PMID: 15161807
- Festa A, et al (2006). The natural course of beta-cell function in nondiabetic and diabetic individuals: the Insulin Resistance Atherosclerosis Study. Diabetes, 55(4), 1114-1120. PMID: 16567536
- DeFronzo RA, Tripathy D (2009). Skeletal muscle insulin resistance is the primary defect in type 2 diabetes. Diabetes Care, 32 Suppl 2, S157-S163. PMID: 19875544
- Ferrannini E, et al (2005). Beta-cell function in subjects spanning the range from normal glucose tolerance to overt diabetes: a new analysis. J Clin Endocrinol Metab, 90(1), 493-500. PMID: 15483086
Medical Disclaimer
This article is for educational purposes only. HOMA-B is a screening tool, not a diagnostic test. Always interpret results with your healthcare provider.