METS-IR: metabolic score for insulin resistance
Insulin resistance — the main precursor of type 2 diabetes — develops for years without symptoms. METS-IR gauges how sensitive your tissues are to insulin without an insulin test: from glucose, triglycerides, HDL and BMI. The higher the index, the lower the sensitivity and the higher the risk of diabetes, cardiovascular events (including heart attack), hypertension and metabolic syndrome.
What METS-IR is and why it matters
In insulin resistance, cells respond less well to insulin, and the pancreas has to produce more and more of it. This hidden process precedes diabetes by years, long before fasting blood sugar rises. The “gold standard” for assessing it (the clamp test) is complex and expensive, so surrogate indices are used instead. METS-IR (Bello-Chavolla, 2018) is one of the most accurate non-insulin indices: it predicts visceral obesity and future type 2 diabetes using only routine labs plus height and weight.
METS-IR Calculator
Enter your height, weight and three fasting blood markers. The calculation runs on the server, and your data is not stored.
How to read METS-IR
| METS-IR | Interpretation | What to do |
|---|---|---|
| ≤ 50.39 | Low risk: insulin sensitivity is preserved | Maintain your lifestyle, track over time |
| > 50.39 | High risk: reduced sensitivity, prediabetes is possible | Check glucose/HbA1c, change your lifestyle, see an endocrinologist |
The 50.39 threshold comes from the original Bello-Chavolla study predicting incident type 2 diabetes. The index is especially valuable over time: a falling METS-IR alongside better nutrition and activity means insulin sensitivity is recovering.
What raises METS-IR
- Visceral fat — fat around the organs directly worsens insulin resistance. The LAP index helps assess it.
- High triglycerides and low HDL — atherogenic dyslipidemia, a companion of insulin resistance.
- Excess weight and a sedentary lifestyle — reduce glucose uptake by muscle.
- Chronic stress and sleep deprivation — raise cortisol and worsen blood-sugar control. The stress level test helps gauge the background.
- A diet high in fast carbohydrates — constant spikes of glucose and insulin.
Frequently asked questions
Why is METS-IR better than insulin-based indices (HOMA-IR)?
METS-IR doesn't require an insulin test, which isn't available everywhere and is less well standardized. It's calculated from routine markers (glucose, lipids, BMI) yet predicts visceral obesity and type 2 diabetes well — handy for screening and follow-up over time.
Which tests are needed and how do I take them?
Glucose, triglycerides and HDL from a fasting blood panel (12 hours without food for lipids), plus height and weight. Units are mmol/L; if your result is in mg/dL, convert it using the hint in the calculator.
Is a high METS-IR already diabetes?
No. A high METS-IR points to elevated risk and likely insulin resistance, but it isn't a diagnosis. Prediabetes and diabetes are confirmed by fasting glucose, HbA1c or an oral glucose tolerance test. With a high result, it's worth checking these markers and seeing an endocrinologist.
How often should I recalculate?
Every 3–6 months makes sense while you're working on your lifestyle or if you have risk factors. A falling index is a good sign the changes are working. Related risks are shown by the diabetes risk assessment and metabolic syndrome.
