Related Experiment Video

Updated: Feb 19, 2026

Study of In Vivo Glucose Metabolism in High-fat Diet-fed Mice Using Oral Glucose Tolerance Test OGTT and Insulin Tolerance Test ITT
08:13

Study of In Vivo Glucose Metabolism in High-fat Diet-fed Mice Using Oral Glucose Tolerance Test OGTT and Insulin Tolerance Test ITT

Published on: January 7, 2018

71.9K

Inappropriate Use of Homeostasis Model Assessment Cutoff Values for Diagnosing Insulin Resistance in Pediatric

Carrie Fox, Lourdes Bernardino, Jill Cochran

    The Journal of the American Osteopathic Association
    |October 31, 2017
    PubMed

    Insights

    Established insulin resistance cutoff values for pediatric patients are lacking scientific support. This review found common Homoeostasis Model Assessment (HOMA) values lack validation, impacting type 2 diabetes risk assessment in children.

    Area of Science:

    • Pediatric Endocrinology
    • Metabolic Research
    • Clinical Diagnostics

    Background:

    • Insulin resistance assessment in children is crucial for identifying type 2 diabetes mellitus risk.
    • Homoeostasis Model Assessment (HOMA) is a common insulin resistance measure, but lacks established pediatric cutoff values.
    • Existing pediatric HOMA cutoff values are widely used in research without clear validation.

    Purpose of the Study:

    • To evaluate the validity of Homoeostasis Model Assessment (HOMA) cutoff values used in pediatric research.
    • To determine the evidential basis for commonly employed HOMA cutoff points in pediatric studies.
    • To assess the reliability of HOMA as a diagnostic tool for insulin resistance in children.

    Main Methods:

    • Systematic review of pediatric studies published between January 2010 and December 2015.
    • Screening of 298 articles for HOMA use in pediatric insulin resistance assessment.
    • Analysis of citation history and references supporting HOMA cutoff values.

    Main Results:

    • 51 different HOMA cutoff values were identified across the analyzed studies.
    • 85.6% of studies used fixed HOMA cutoff values, but only 28.2% provided supporting references.
    • Many commonly used HOMA cutoff values lack validated evidence and are based on unverified sources.

    Conclusions:

    • There is a significant lack of evidence supporting the HOMA cutoff values currently used in pediatric research.
    • The study underscores the need for rigorous validation of study design elements, including diagnostic criteria.
    • Developing population-specific HOMA ranges is recommended to enhance its clinical utility in pediatric populations.
    Abstract

    More Related Videos

    Hyperinsulinemic-Euglycemic Clamp in the Conscious Rat11:12

    Hyperinsulinemic-Euglycemic Clamp in the Conscious Rat

    Published on: February 7, 2011

    54.4K
    Author Spotlight: Exploring the Impact of Reduced Resistance Exercise Volume on Metabolic Health06:13

    Author Spotlight: Exploring the Impact of Reduced Resistance Exercise Volume on Metabolic Health

    Published on: December 1, 2023

    1.8K

    Related Concept Videos

    Insulin: Dosing Regimen and Adverse Effects01:16

    Insulin: Dosing Regimen and Adverse Effects

    Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
    The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
    874
    Homeostatic Imbalance01:10

    Homeostatic Imbalance

    Homeostasis is the maintenance of a stable internal environment within the body, which is crucial for the proper functioning of cells, tissues, organs, and organ systems. The body has various control mechanisms that work together to regulate various physiological parameters such as temperature, blood pressure, pH balance, and fluid balance, to name a few. These control mechanisms are based on feedback loops that can be either positive or negative.
    However, sometimes these feedback loops fail,...
    36.2K
    Diabetes: Symptoms, Diagnosis, and Complications01:15

    Diabetes: Symptoms, Diagnosis, and Complications

    For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
    2.4K
    Diabetes Mellitus: Overview and Type I Subtype01:22

    Diabetes Mellitus: Overview and Type I Subtype

    Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
    Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
    5.6K
    Hypoglycemia and Glucagon01:15

    Hypoglycemia and Glucagon

    Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
    1.0K
    Diabetes Mellitus: Type 2 and Gestational01:22

    Diabetes Mellitus: Type 2 and Gestational

    Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
    5.1K