HOMA-IR Before Pregnancy

If HOMA-IR testing was included as a part of every standard physical examination starting from a young age, would women still continue to alarmingly receive the sudden and serious diagnosis of gestational diabetes? Typically women are given a glucose screening test between 24 and 28 weeks of pregnancy, and many of these women have never had a glucose test before. Early screening for gestational diabetes is typically only recommended if a woman has certain risk factors like obesity or a strong family history of diabetes.

Unfortunately, gestational diabetes cases are on the rise. The complications can be very serious and even fatal for both mother and baby, including pre-term birth, stillbirth, and large birth weight. Gestational diabetes also increases a woman's risk of high blood pressure and subsequent preeclampsia.

The 2014 study Estimating Rate of Insulin Resistance in Patients with Preeclampsia Using HOMA-IR Index and Comparison with Nonpreeclampsia Pregnant Women found that insulin resistance was significantly higher in patients with preeclampsia than the control group. It was concluded that insulin resistance is an important risk factor in predicting preeclampsia and that interventions to reduce insulin resistance may halt gestational hypertension.

The 2017 study A Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) Relates to Gestational Diabetes, Glycemic Control concluded that "HOMA-IR is a simplified measure of insulin resistance and may predict both which pregnant women are at risk for gestational diabetes and which patients with gestational diabetes are most likely to require medical therapy."

The 2008 study Diagnosis of Gestational Diabetes by use of the Homeostasis Model Assessment-Insulin Resistance Index in the First Trimester compared HOMA-IR tests done in the first trimester of pregnancy with the second-trimester glucose tolerance test. They found first trimester HOMA-IR values were higher in women that eventually failed the second trimester glucose tolerance test and were diagnosed with gestational diabetes. Patients with HOMA-IR values higher than 2.60 in the first trimester seems to be a good method to predict gestational diabetes, the study concluded.

Looking beyond the prevention of substantial pregnancy complications, I find it clear through all of the research I have seen and will continue to see that it is simply crucial to make testing for insulin resistance beginning at a young age far more common. The myth that insulin resistance is a problem that occurs only in obese people desperately needs to be dispelled, and the ways in which this problem can affect the human body are incredibly vast.