Biomarkers of Blood Glucose Regulation: HOMA2-%S

Optimal Takeaways

HOMA2-%S reflects the sensitivity of peripheral tissues to insulin. The higher the value, the more responsive cells are to insulin. Decreasing sensitivity will be seen in insulin resistance, prediabetes, and type 2 diabetes. HOMA2-%S should be assessed alongside HOMA2-%B and HOMA2-IR

Standard Range: 75-250%

The ODX Range: 85-200%

Low HOMA2-%S indicates a declining sensitivity to insulin and poorer glycemic control.

High HOMA2-%S indicates greater tissue sensitivity to insulin and should translate into better glycemic control. However, extreme insulin sensitivity (higher HOMA2-%S) may contribute to reactive hypoglycemia.

Overview

HOMA2-%S reflects the responsiveness (sensitivity) of peripheral tissues to insulin, and their ability to take up glucose from the bloodstream. When insulin is chronically elevated due to persistently elevated glucose, tissue insulin sensitivity and HOMA2-%S values decrease. The lower the HOMA2-%S, the less responsive cells are to insulin. It is important to look at all HOMA2 values (e.g., HOMA2-IR, -%B, and %S) in order to evaluate where an individual is on the blood sugar dysregulation spectrum (Caumo 2006, Ghasemi 2015, Raverdy 2016).

Prediabetes and the early stages of T2DM are characterized by a decreased HOMA2-%S, an elevated HOMA2-IR, and an elevated HOMA2-%B as the body tries to control elevated blood glucose. Eventually, beta cells begin to fail, insulin output decreases, HOMA2-%S and HOMA2-%B both decrease, and HOMA2-IR increases.

References

Caumo, Andrea et al. “New insights on the simultaneous assessment of insulin sensitivity and beta-cell function with the HOMA2 method.” Diabetes care vol. 29,12 (2006): 2733-4. doi:10.2337/dc06-0070

Ghasemi, Asghar et al. “Cut-off points of homeostasis model assessment of insulin resistance, beta-cell function, and fasting serum insulin to identify future type 2 diabetes: Tehran Lipid and Glucose Study.” Acta diabetologica vol. 52,5 (2015): 905-15. doi:10.1007/s00592-015-0730-3

Raverdy, Violeta et al. “Incidence and Predictive Factors of Postprandial Hyperinsulinemic Hypoglycemia After Roux-en-Y Gastric Bypass: A Five year Longitudinal Study.” Annals of surgery vol. 264,5 (2016): 878-885. doi:10.1097/SLA.0000000000001915