Correlation of Triglyceride-Glucose Index with Diabetic Retinopathy in Nepal
Overview
This cross-sectional study in Nepal evaluated the association between the triglyceride-glucose (TyG) index and diabetic retinopathy (DR) among diabetic patients. The TyG index showed a significant correlation with the presence and severity of DR, suggesting its potential utility as a simple screening marker in resource-limited settings.
Background
Diabetic retinopathy is a leading microvascular complication of diabetes mellitus and a major cause of preventable vision loss globally. Insulin resistance plays a central role in the pathogenesis of diabetic complications, including DR. The TyG index, derived from fasting plasma glucose and triglyceride levels, is a validated surrogate marker of insulin resistance and is easily obtainable in routine clinical practice. While prior studies have linked the TyG index to diabetic microvascular complications, data from South Asian populations, including Nepal, remain limited.
Data Highlights
Parameter
Value/Description
Sample Size
82 patients with diabetes mellitus
TyG Index Calculation
Based on fasting plasma glucose and triglyceride levels
DR Prevalence
Approximately 31% anticipated based on prior literature
DR Classification
No DR, mild, moderate, severe non-proliferative, proliferative DR
The TyG index was significantly correlated with diabetic retinopathy prevalence and severity among Nepalese diabetic patients.
Higher TyG index quartiles were associated with increased frequency and severity of DR.
Logistic regression showed that each standard deviation increase in TyG index raised the odds of DR, independent of other risk factors.
The TyG index correlated positively with HbA1c, supporting its link with glycemic control and insulin resistance.
TyG index demonstrated potential as a cost-effective screening tool for early identification of patients at risk for diabetic retinopathy in resource-limited settings.
Clinical Implications
Clinicians in Nepal and similar settings may consider incorporating the TyG index into routine diabetes management to identify patients at higher risk for diabetic retinopathy. Early detection through this simple marker could facilitate timely ophthalmic referral and intervention, potentially reducing vision loss. The TyG index’s reliance on commonly available laboratory tests makes it feasible for widespread use where advanced insulin resistance testing is unavailable.
Conclusion
The study supports the TyG index as a valuable surrogate marker correlated with diabetic retinopathy presence and severity in Nepalese diabetic patients. Its implementation could enhance early risk stratification and guide preventive ophthalmic care in resource-constrained environments.
References
International Clinical Diabetic Retinopathy Severity Scale -- 2020
Meta-analyses on Diabetic Retinopathy Prevalence -- Various Authors
Studies on TyG Index and Insulin Resistance -- 2018-2023
Age-related macular degeneration (AMD) is among the most common retinal diagnoses. Although the clinical features of the disease are well known, ICD-10 coding can be confusing if details such as stage, activity, and laterality are not clearly documented. Incomplete documentation may prompt questions about the medical necessity of diagnostic tests or intravitreal injections. This Q&A addresses common sources of confusion and offers practical guidance to support clear, accurate documentation.
"AI could help reduce the burden on ophthalmology services by triaging large numbers of patients with diabetes and allowing specialists to focus on those who most urgently need care."
