Background and aim: Recent research articles suggest that a low urine pH related to more complications in type 2 diabetes mellitus. Our aim was to study of insulin resistance in type 2 diabetes patients using homeostasis model assessment and analysis of fasting urine pH as a predictor of insulin resistance in type 2 diabetes. Materials and methods: This prospective study was conducted in our hospital with type 2 diabetes mellitus patients during the period 2019 to 2020. A total of 102 patients have been taken for the study. Participants were isolated into two groups with urine pH <5.5 and the group with urine pH >= 5.5. We then further investigated the association between low urine pH levels and insulin resistance. Descriptive data were shown as the mean value of (Standard error) or number (%). The unpaired two sample t-test was used for analysis of continuous variables and the Chi-square test used for estimation of categorical variables. Results: Participants with urine pH <5.5 have high fasting blood glucose, HOMA IR index,high triglycerides (P values <0.0001,P values <0.04, and P values <0.001 respectively) whereas patients with urine pH >5.5 have strong positive association with lower triglycerides levels and better glycemic control indicated by low HbA1C(P values <0.001,P values <0.0001 respectively). A significant inverse relationship was observed between urine pH levels and the extent of insulin resistance Conclusion: These observational findings concluded that fasting low urine pH can be used as simple, noninvasive, and easily available tool to estimate insulin resistance.