METS-IR calculator

The formula

METS-IR is the natural log of (2 × fasting glucose + fasting triglycerides), times BMI, divided by the natural log of HDL cholesterol (Bello-Chavolla 2018). Glucose, triglycerides and HDL are in mg/dL (Gao 2026) (Liu 2026). If your lab reports mmol/L, we first convert: glucose times 18, triglycerides times 88.57 and HDL times 38.67. For example, glucose of 90 mg/dL, triglycerides of 150 mg/dL, HDL of 50 mg/dL and a BMI of 25 give ln(330) × 25 ÷ ln(50) = 37.1.

The original paper defines the score in its abstract, and the abstract does not name the units. We read the units from two later open papers that print the formula with them (Gao 2026) (Liu 2026). With mg/dL, typical results land on the same scale as the averages the original study reports (about 45 to 50).

What the study found

The researchers wanted a fasting score that does not need an insulin result. In 125 adults who had the euglycemic-hyperinsulinemic clamp, the reference research test of insulin sensitivity, METS-IR had a correlation of -0.622 with the clamp result, and an area under the curve of 0.84 for spotting impaired insulin sensitivity. It was also linked with visceral fat and with fat in the liver and pancreas measured by imaging (Bello-Chavolla 2018).

In 6,144 people followed for about two years, those who developed type 2 diabetes had a higher METS-IR at the start than healthy controls (average 50.2 versus 44.7). People in the highest quarter, above 50.39, had the highest adjusted risk of new type 2 diabetes (hazard ratio 3.91) (Bello-Chavolla 2018). These are figures from one study, not a cutoff for your result.

Why there is no "normal" line here

No guideline sets a normal range for METS-IR, and the study quarter above 50.39 describes that study's group, not a diagnosis. The National Institute of Diabetes and Digestive and Kidney Diseases says health care professionals may not test for insulin resistance, and that the test is used mainly in research studies (NIDDK). Insulin resistance often goes with a larger waist, high blood pressure and abnormal blood fats; see the metabolic syndrome criteria.

Not a diabetes test

Diabetes and prediabetes are diagnosed with an A1C, a fasting plasma glucose or an oral glucose tolerance test, not with METS-IR (ADA Standards 2026). Your fasting glucose on its own already tells you more for that question: see prediabetes ranges and next steps. To see your overall chance of type 2 diabetes, take the diabetes risk test.

METS-IR, TyG index or HOMA-IR?

All three are research estimates of insulin resistance, and none has a single agreed cutoff. The HOMA-IR calculator needs a fasting insulin result. The TyG index uses only fasting triglycerides and glucose. METS-IR adds HDL cholesterol and BMI. The atherogenic index of plasma compares triglycerides with HDL cholesterol as a heart research marker, and the triglyceride to HDL ratio does so without the logarithm.

Getting the right numbers

Use glucose, triglycerides and HDL cholesterol from the same fasting blood draw. For a fasting blood sugar test, NHLBI says to fast for 8 to 12 hours (NHLBI). The score was built on fasting results, so non-fasting results should not be used here.