Abstract
Introduction: Insulin resistance (IR) and glycemic control are two very important aspects to be considered during management of patients with Type 2 Diabetes Mellitus (T2DM). The triglyceride-glucose (TyG) index has been proposed as a simple and inexpensive parameter that correlates well with IR and glycemic control.
 Objectives: To explore the association of TyG index (and other TyG derived indices) with glycated hemoglobin (HbA1c) and evaluate their predictive ability for glycemic control in patients with T2DM.
 Methodology: This cross-sectional study comprised of 160 adult patients diagnosed with T2DM visiting the medical outpatient department of Chitwan Medical College, Bharatpur, Chitwan between July–December 2019. Socio-demographic data and anthropometric measurements were collected. Glycemic control was assessed by HbA1c. TyG index was calculated by the formula: ln [fasting TG (mg/dl) x fasting glucose (mg/dl)/2]. Receiver operating characteristic (ROC) curve analysis was performed to analyze the predictive ability of TyG-index for poor glycemic control.
 Results: One hundred and sixty patients (mean age: 53.6 ± 10.7 years, 55.0% males) were included in the study. Eighty (50.0%) had good glycemic control (HbA1c <7.0%). TyG index, along with TyG-BMI and TyG-WC (other TyG derived indices) were significantly increased in the poor glycemic control group. TyG index had a good predictive ability for poor glycemic control (AUC: 0.803, 95% CI: 0.731 – 0.874). A TyG cutoff ≥ 9.12 was optimal for predicting poor glycemic control, with 86.1% sensitivity and 61.5% specificity.
 Conclusion: TyG index could be a simple and cost-effective screening tool for assessment of glycemic control in patients with T2DM.
Highlights
The global prevalence of type 2 diabetes mellitus (T2DM), a common metabolic disorder characterized by hyperglycemia and insulin resistance is ever increasing; and has been regarded as a major public health issue.[1]
The triglyceride-glucose (TyG) index is a simple, inexpensive parameter that has been suggested as a surrogate marker for insulin resistance, closely correla ng with Homeostasis Model Assessment of Insulin Resistance (HOMA-Insulin resistance (IR)).[7]
Insulin resistance supposedly contributes to poor glycemic control, hypertension, dyslipidemia and accelerated atherosclerosis.[8]
Summary
The global prevalence of type 2 diabetes mellitus (T2DM), a common metabolic disorder characterized by hyperglycemia and insulin resistance is ever increasing; and has been regarded as a major public health issue.[1]. It has been shown to have a strong predic ve value for diabetes complica ons.[3,4] The frequency of HbA1c tes ng has been recommended to be guided by the clinical situa on, treatment regimen and the clinicians’ judgement according to recent guidelines[5], frequent tes ng in low-income countries is s ll limited by its high cost and inadequate availability of standardized assays.[6]. We expect TyG index to have a sa sfactory ability to discriminate pa ents with poor glycemic control, sugges ng its clinical u lity in type 2 DM
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