A novel mathematical model named HOMA-C, based on fasting insulin and glucose, aims to better estimate pancreatic reserve capacity, potentially improving prediction of progression from prediabetes to type 2 diabetes.
A new model described in PLOS Computational Biology proposes a way to estimate how much spare insulin-producing capacity the pancreas may still have before prediabetes tips into type 2 diabetes. The approach, called HOMA-C, is designed to complement established fasting-blood-test measures such as HOMA-IR, which estimates insulin resistance, and HOMA-B, which estimates current beta-cell function. The authors say the new formula is intended to capture beta-cell “carrying capacity” – the maximum functional reserve an individual may be able to reach under stress.
The paper argues that this reserve matters because many people can remain near-normal in glucose despite substantial insulin resistance, thanks to compensation from beta cells. According to the authors, that compensation is not uniform: some people appear able to increase insulin output far more than others, and those with less reserve may be more likely to develop prediabetes and then diabetes. The study also notes that HOMA-C is built from fasting insulin and glucose measurements, using a mathematical model of glucose-insulin dynamics rather than a direct clinical test.
In a longitudinal cohort of untreated people with prediabetes, the researchers reported roughly a tenfold spread in estimated carrying capacity across individuals. They said low HOMA-C was linked to a greater chance of moving into diabetes over one year, with the lowest quartile carrying around four times the risk seen in the highest quartile. The paper adds that HOMA-C appeared to outperform HOMA-B, HOMA-IR, HbA1c and a HOMA-based disposition index in predicting progression, although fasting glucose-based measures remained very strong predictors.
The findings fit with earlier work showing that HOMA-based calculations can be useful research tools for studying insulin resistance and beta-cell function, while also underscoring their limits. The authors stress that HOMA-C is a model-based estimate, not a direct measurement, and they say it needs further experimental validation before it can be treated as a firm biological marker. Even so, the study suggests that quantifying beta-cell reserve may help sharpen risk assessment in prediabetes, a condition that affects an estimated 10% to 30% of adults worldwide and often progresses silently.
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