2nd Edition of Diabetes and Endocrinology World Conference 2026

Abstract

Type 2 diabetes mellitus (T2DM) continues to rise globally, particularly in low- and middle-income countries, where a large proportion of cases remain undiagnosed until complications develop. Early identification of individuals at risk in community and primary care settings is therefore essential to reduce long-term metabolic and cardiovascular burden. Conventional assessments of insulin resistance, such as insulin-based indices, are often impractical for population-level screening due to cost and limited laboratory capacity.

The triglyceride–glucose (TyG) index, calculated from routine fasting triglyceride and glucose measurements, has emerged as a simple and low-cost surrogate marker of insulin resistance. This systematic review aimed to evaluate the performance and applicability of the TyG index as a community-based screening tool for early detection of type 2 diabetes risk in young and adult populations.

A systematic literature search was conducted in PubMed, Scopus, Web of Science, and MEDLINE for studies published between 2015 and 2025. Observational studies conducted in community or primary care settings were included if they reported TyG cut-off values and diagnostic accuracy measures, such as sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). Data extraction included study design, population characteristics, TyG thresholds, and performance metrics. Methodological quality was assessed using the QUADAS-2 tool. Due to heterogeneity across populations, reference standards, and outcome definitions, a qualitative synthesis was performed.

Seventeen studies from Asia, Latin America, and Europe met the inclusion criteria. Reported TyG cut-off values varied across populations and clinical contexts. Across most studies, elevated TyG index values were consistently associated with insulin resistance, impaired fasting glucose, incident T2DM, or related metabolic risk indicators. Several studies demonstrated diagnostic performance comparable to or exceeding insulin-based indices such as HOMA-IR, supporting the feasibility of the TyG index as a screening marker using routinely available laboratory data.

In conclusion, the TyG index represents a feasible, reliable, and low-cost biomarker for community-level screening of type 2 diabetes risk. Its reliance on routine biochemical parameters makes it particularly suitable for large-scale implementation in primary care and resource-limited settings. Population-specific validation of cut-off values and cost-effectiveness analyses are recommended to support broader adoption in national and community-based screening programs.