Clinical Utility of the Triglyceride-Glucose Index in Identifying Poor Glycemic Control in Type 2 Diabetes Mellitus: A Cost-Effective Audit.

BACKGROUND

Poor glycemic control in type 2 diabetes mellitus (T2DM) is common and leads to serious complications. The triglyceride-glucose (TyG) index is a simple and low-cost marker that may help identify poor glycemic control using routine tests.

OBJECTIVE

This study aimed to assess the clinical utility of the TyG index in identifying poor glycemic control in patients with T2DM.

METHODS

This observational audit was conducted at the Punjab Institute of Cardiology, Lahore, from February 18, 2025, to February 17, 2026. A total of 412 patients with complete requisite data were analyzed. The TyG index was calculated using fasting triglycerides and fasting blood glucose. Poor glycemic control was defined as HbA1c ≥7.0%. Statistical analysis included group comparison, receiver operating characteristic (ROC) curve analysis, and multivariable logistic regression.

RESULTS

Poor glycemic control was observed in 262 (63.6%) patients. The TyG index was significantly higher in patients with poor glycemic control compared to good glycemic control (9.12 ± 0.54 vs. 8.52 ± 0.41, p < 0.001). ROC analysis showed good diagnostic performance (AUC = 0.81), with an optimal cutoff value of 8.78, sensitivity of 78.2%, and specificity of 72.0%. On multivariable analysis, the TyG index remained an independent predictor of poor glycemic control (AOR = 3.84, 95% CI: 2.45-6.02, p < 0.001). The duration of T2DM and BMI were also significant predictors.

CONCLUSION

The TyG index is a simple, cost-effective, and reliable marker for identifying poor glycemic control in T2DM patients. It can be useful in routine clinical practice, especially in low-resource settings, where affordability and lack of cutting-edge healthcare facilities are a concern.