TyG index: the simplest way to assess insulin resistance

The TyG Index (Triglyceride-Glucose Index) is a calculated measure based on serum glucose and triglyceride levels, used to assess insulin resistance.

One of the most important benefits of the TyG Index is that it only requires two straightforward routine tests, eliminating the need for insulin level measurements.

Insulin resistance is a condition where various body tissues have a diminished ability to absorb glucose from the bloodstream in response to insulin. Over time, this dysfunction, along with inadequate insulin production from the pancreas, can lead to the onset of type 2 diabetes mellitus (DM2).

Insulin is a hormone made by the pancreas that helps cells take in glucose. In cases of insulin resistance, the sensitivity of cells to this hormone decreases, which hampers glucose absorption.

Insulin resistance also increases the breakdown of fat (lipolysis) in fat cells, resulting in higher levels of free fatty acids in the bloodstream and reduced glycogen storage in the liver. This process encourages the production of glucose (gluconeogenesis).

When systemic insulin resistance occurs, it leads to an increase in insulin secretion, which further stimulates the liver to produce new fat (de novo lipogenesis). This can cause fat to accumulate in the liver and raise levels of low-density lipoproteins (LDL) in the blood. Excess fat can also build up in peripheral fat tissue, which has a limited capacity for storage.

Lipotoxicity can interfere with insulin signaling, cause oxidative damage, and promote inflammation and fibrosis, potentially leading to more serious liver conditions, from simple fatty liver to fibrosis or even cancer.

For accurately diagnosing insulin resistance, advanced techniques are necessary to assess glucose utilization during induced hyperinsulinemia.

To make this determination easier, simpler models have been developed based on epidemiological studies that connect fasting glucose and insulin levels, such as the TyG Index, the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), or the Quantitative Insulin Sensitivity Check Index (QUICKI).

The TyG Index showed a good predictive capacity for cardiovascular risk in ten years assessed by the Framingham risk score (FRS).

Engaging in physical activity and, if needed, losing weight can enhance the body's insulin response. Simple changes, like choosing healthier foods and increasing activity levels to shed pounds, can help reverse insulin resistance and may also prevent or delay the onset of type 2 diabetes mellitus (DM2) in individuals with prediabetes.

Moreover, it's advisable to speak with a healthcare professional about various prevention programs. These include primary prevention, which focuses on reducing the occurrence of a disease through measures like vaccination programs or awareness campaigns aimed at changing high-risk behaviors; secondary prevention, which aims to lower the prevalence of a disease by implementing strategies to halt or slow the progression of an existing condition at any stage, such as through screening or early detection initiatives; and tertiary prevention, which seeks to prevent complications or further damage by managing the progression of the disease, for instance, through regular monitoring of chronic patients.