Triglyceride-Glucose Index as a Predictor for Glycaemic Control in Type 2 Diabetes: A Retrospective Study among Patients Attending Hospital in Accra

Abstract

Objectives: Type 2 diabetes mellitus (T2DM) is a chronic, silent non-communicable disease that has taken a toll on the global community due to lifestyle modifications. Glycaemic control is the maintenance of plasma glucose concentration within prudent limits to prevent or delay complications associated with T2DM. The current study evaluated the use of Triglyceride-Glucose (TyG) index as a cheaper and cost-effective option that could function as a supportive marker to complement the role of HbA1c in the management of T2DM individuals in Ghana. Study Design:  This is a retrospective study. Place and Duration of Study: This study retrieved the clinical records of 1031 outpatients, aged 12 to 106 years, who received medical care at the Trust Hospital in Accra, Ghana from 2018 and 2020. Materials and Methods: Records of socio-demography, laboratory data including lipid profile, HbA1c, fasting blood glucose (FBG), and exploratory parameters such as systolic blood pressure (SBP), diastolic blood pressure (DBP), weight, height, and body mass index (BMI) were retrieved. The TyG index was derived from triglyceride and plasma glucose concentrations as follows; TyG index = Ln[fasting Triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2]. Descriptive and inferential statistical analyses were performed using Stata version 16.1 and SPSS version 27. Results: In this study, 425 (41.2%) of the study participants recorded good glycaemic control (HbA1c <7.0%) while 606 (58.8%) recorded poor glycaemic control (HbA1c≥7), with a mean HbA1c of 8.3%. There was a significant positive correlation between the TyG index and glycated haemoglobin (r=0.53, P<.001). The ROC curve analysis identified 9.0 as the optimal cutoff value for predicting disease, based on the Youden Index. At this threshold, the test showed a sensitivity of 68.8% and a specificity of 75.9%. The AUC of 0.777 (95% CI: 0.748 – 0.805; P-value ≤.000) shows the ability of TyG index to predict glycaemic control in T2DM individuals. Conclusion: TyG index is a good predictive marker for poor glycaemic control in individuals with T2DM diabetes and could function as a supportive marker that may complement the role of HbA1c in the management of T2DM.