Fasting Insulin / HOMA-IR
Last reviewed 25 August 2026 · Evidence-graded review — see Methodology
Fasting insulin and glucose combined into a single index — fasting insulin × fasting glucose ÷ 22.5 — as an estimate of insulin resistance. The physiological rationale is sound: insulin resistance can precede dysglycaemia by years and independently associates with cardiometabolic risk.
Matthews DR, Hosker JP, Rudenski AS, et al. “Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man.” Diabetologia 1985;28(7):412–419 is the original validation against the euglycaemic clamp, and HOMA-IR does correlate with future type 2 diabetes and cardiometabolic risk in cohort studies. What it lacks is standardisation and consequence. Fasting insulin assays are not standardised across laboratories or platforms, reference ranges vary widely, no major guideline recommends routine HOMA-IR screening in asymptomatic adults, and no trial shows that acting on an isolated elevated HOMA-IR — beyond what glucose and HbA1c already prompt — changes outcomes.
Matthews DR, et al. Diabetologia. 1985. PubMed: PMID 3899825
Singapore guidance
Not one of the named screening tests
Not among the tests Singapore’s national screening committee names for diabetes screening, which specifies fasting plasma glucose or HbA1c.
Source: Screening Test Review Committee report 2026, Volume 1 (Academy of Medicine Singapore and Ministry of Health, February 2026). The full national list · How this is used.
What you would actually pay
- Healthier SG
- Not subsidised
- MediSave
- Not among the screenings named for outpatient claims
Source: Healthier SG Screening (HealthHub) and MediSave outpatient care (Ministry of Health). Absence from either list is not a statement that the test is discouraged — only that no subsidy or claim applies. Gross prices compared.
What it costs when it is wrong
- Basis
- No published harm criterion found
- Severity
- Not documented
No published harm criterion found for this test.
An empty finding, not a clean bill of health: this means nothing documented was found for this test. It is not a claim that the test is safe.
Screening harm is not only a laboratory question: the committee’s own criteria advise against a test when “the screening test, or follow-up tests arising from a positive screen, are associated with significant medical risks”. Sources on overdiagnosis → · How this is graded.
FAQ
Is the Fasting Insulin / HOMA-IR worth doing in Singapore?
Fasting Insulin / HOMA-IR holds a weak evidence grade under our screening rubric. It is most appropriate for select cases (e.g. PCOS workup) or research interest — not a validated standalone longevity screen. It typically costs S$40–60 in Singapore. It is not routinely recommended.
Weighing this against something else? Compare it with two other tests → · Price it inside a panel →