Clinical Report: Identifying Prevalent Type 2 Diabetes in Older Adults

Overview

This study evaluates the associations and discriminatory abilities of 12 insulin resistance indices for prevalent type 2 diabetes mellitus (T2DM) in older adults with metabolic dysfunction-associated fatty liver disease (MASLD).

Background

The coexistence of metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (T2DM) is a significant public health concern, particularly in older adults. Effective screening tools for T2DM in this population are essential for early intervention and management. Insulin resistance is a key factor linking MASLD and T2DM.

Data Highlights

Key Findings

• TyG, TyG-ABSI, TyG-WWI, and TyG-WC were significantly associated with prevalent T2DM (P < 0.05).
• TyG showed the highest discriminatory ability with an AUC of 0.726.
• The optimal cut-off value for TyG was determined to be 9.225.
• Even after excluding T2DM cases defined solely by fasting plasma glucose, TyG remained the best-performing index (AUC = 0.707).
• RCS analyses indicated significant overall associations without supporting nonlinearity for the indices.
• No significant interactions were observed in subgroup analyses.

Clinical Implications

The findings indicate that TyG and its variants are associated with prevalent T2DM in older adults with MASLD.

Conclusion

The study highlights the associations of TyG with prevalent T2DM in older adults with MASLD.

Related Resources & Content

1. Frontiers in Endocrinology, 2026 -- TyG-WHtR predicts incident type 2 diabetes mellitus in NAFLD: a 12-year prospective cohort study
2. Frontiers in Endocrinology, 2026 -- Comparative discriminative ability of CVAI and traditional insulin resistance indices for MAFLD in Chinese adults with type 2 diabetes
3. The Journal of Clinical Endocrinology & Metabolism -- Association of Liver Fat Accumulation with Elevated Insulin Secretion Regardless of Total, Visceral, and Pancreatic Fat Levels
4. The Journal of Clinical Endocrinology & Metabolism — Insulin Resistance and Its Link to Cardiometabolic Risk in Nonobese Individuals at Risk of Prediabetes (STOP DIABETES)
5. ADA Standards of Care 2026
6. EASL-EASD-EASO Clinical Practice Guidelines on MASLD
7. NDA 215256/S-024 Accelerated Approval letter
8. Drug Trials Snapshots: REZDIFFRA | FDA
9. TyG-WHtR predicts incident type 2 diabetes mellitus in NAFLD: a 12-year prospective cohort study - PMC
10. Association of triglyceride glucose-body mass index (TyG-BMI) with metabolic dysfunction-associated steatotic liver disease: A systematic review and meta-analysis - PMC
11. Association between the insulin resistance indices and incident type 2 diabetes across different body mass index states: a cohort study and external validation from two East Asian populations - ScienceDirect