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.