Type 2 Diabetes Mellitus (T2DM) has become one of the most pressing global health concerns, with its prevalence rising steadily across populations and contributing substantially to cardiovascular morbidity and mortality (1). At the core of this condition lies insulin resistance, a state in which tissues fail to respond adequately to insulin, resulting in impaired glucose uptake and chronic metabolic imbalance (2). The Homeostatic Model Assessment of Insulin Resistance (HOMA IR), derived from fasting glucose and insulin levels, is a simple, validated, and cost effective tool in both clinical practice and epidemiological research (3,4). Cardiovascular disease (CVD) remains the leading cause of death among individuals with diabetes, and insulin resistance is increasingly recognized as a central driver of this risk (5). It contributes to endothelial dysfunction, oxidative stress, platelet activation, and low grade inflammation, all of which accelerate atherosclerosis (6). In addition, the dyslipidemia characteristic of insulin resistance—marked by elevated triglycerides, reduced HDL cholesterol, and small dense LDL particles—further amplifies cardiovascular risk (7). Metabolomic studies have also highlighted lipid intermediates such as lysophosphatidylcholines, which correlate with oxidative stress and arterial stiffness, reinforcing the vascular impact of insulin resistance (8). Evidence from prospective studies shows that HOMA IR is independently associated with cardiovascular events, even after adjustment for conventional risk factors (9). Meta analyses confirm its predictive value, often surpassing fasting glucose or insulin alone in forecasting coronary heart disease (10). Population based studies have established cut off values that vary by age, sex, and ethnicity, underscoring the importance of contextualized thresholds (11,12). Indian studies have further refined these cut offs, emphasizing the unique metabolic risk profile of South Asian populations (13,14,15). Early studies established a strong link between insulin resistance and subclinical cardiovascular disease, while more recent evidence has confirmed its predictive role in cardiometabolic risk across diverse populations.(16,17) Although HOMA IR is a valuable marker of insulin resistance, it is not yet routinely incorporated into cardiovascular risk assessment. Integrating this index with established ASCVD risk scores and the newer Cardiovascular-kidney-metabolic (CKM) syndrome staging has been suggested as a practical way to identify patients at higher risk (18). Detecting insulin resistance early provides an opportunity for timely lifestyle changes and pharmacological treatment, which can significantly reduce the long term burden of cardiovascular disease (19,20). This study therefore aims to assess insulin resistance using HOMA IR in patients with T2DM and to explore its association with cardiovascular risk, as quantified by ASCVD scores. By bridging metabolic and cardiovascular parameters, the research seeks to establish HOMA IR as a clinically relevant marker for individualized preventive care in diabetes.