Triglyceride–Glucose Index: A Cost-effective Alternative to HbA1c for Glycemic Monitoring in Type 2 Diabetes: A Cross-sectional Study at a Tertiary Care Center in Uttar Pradesh

Insulin resistance, a key pathophysiological feature of T2DM, affects both glucose uptake and lipid metabolism, leading to characteristic dyslipidemia patterns. 6he TyG index, which combines measurements of fasting triglycerides and glucose levels, has emerged as a promising indicator of insulin resistance (IR).This index correlates well with the hyperglycemic clamp technique, which is considered the gold standard for measuring insulin resistance. 7,8Beyond its primary application, the TyG index has proven valuable in identifying individuals who, despite having normal weight, exhibit metabolic obesity characteristics. 9Studies have also indicated its utility in predicting various health conditions, including coronary artery calcification, subclinical atherosclerosis, 10 and nonalcoholic IntroductIonType 2 diabetes mellitus (T2DM) represents one of the most significant public health challenges of the 21st century, affecting approximately 10.5% of the global population and 8.3% of the Indian population. 1 The International Diabetes Federation estimates that by 2045, the number of people with diabetes will rise to 783 million, which would be an increase of 46% globally, placing an unprecedented burden on healthcare systems worldwide. 1As per the Indian Council of Medical Research-India Diabetes (ICMR INDIAB) study published in 2023, the prevalence of diabetes is 10.1 crores. 2 Glycemic control monitoring remains a cornerstone in T2DM management, with HbA1c serving as the gold-standard marker.HbA1c provides valuable information about average blood glucose levels over the preceding 2-3 months and has shown strong correlations with diabetes-related complications. [3][4]][5] However, several limitations af fect its widespread use, particularly in resource-constrained settings.These include cost considerations, limited accessibility in rural areas, and variations in results due to conditions affecting red blood cell turnover such as iron deficiency anemia, B12 deficiency anemia, folate deficiency anemia, chronic alcohol use, and asplenia, which falsely elevate HbA1c, and acute and chronic blood loss, hemolytic anemia, splenomegaly, and pregnancy, which falsely reduce HbA1c levels. 4,5ecent research has highlighted the intricate relationship between glucose metabolism and lipid homeostasis in T2DM.