Triglyceride-Glucose Index as a Predictor of DiabeticFoot Ulcer Severity in Type 2 Diabetes Mellitus:Cross-Sectional Study

Authors

  • Istiqomah Department of Internal Medicine, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, Indonesia Author
  • Fauzia Noor Liani Division of Endocrine Metabolism, Department of Internal Medicine, Ulin Hospital Banjarmasin, Indonesia Author
  • Mohammad Bakhriansyah Division of Pharmacology, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, Indonesia Author

DOI:

https://doi.org/10.66266/inajemd.v2i2.58

Keywords:

TyG index, type 2 DM, diabetic foot ulcers

Abstract

Introduction: Diabetic foot ulcers are a complication of type 2 diabetes mellitus that has a
high global prevalence. Insulin resistance in type 2 DM patients tends to cause chronic wounds and can delay wound healing. TyG index is currently used as a surrogate biomarker to evaluate insulin resistance because it is easy to perform and low cost.
Methods: Analytic observational research with a cross-sectional approach at Diabetic Foot Poly Ulin Hospital Banjarmasin. The study sample was all patients diagnosed with type 2 DM and undergoing wound care at the Diabetic Foot Polyclinic of Ulin Hospital Banjarmasin starting in December 2024 who met the inclusion and exclusion criteria with a total of at least 74 people. Data analysis was performed with a simple binomial logistic regression test to estimate crude Prevalence Odds Ratio (POR) with 95% confidence intervals, and multiple binomial logistic regression tests were performed to estimate adjusted POR and 95%CIs.
Results: Compared with the lowest one-third TyG Index score, study subjects with the middle
one-third TyG Index score were associated with a lower risk of severe diabetic foot ulcer incidence by 85.9% (Adj POR 0.141, 95% CI: 0.011-1.802). Subjects with the highest third TyG Index value were also associated with a lower risk of diabetic foot ulcer incidence of 87.1% (Adj POR 0.129, 95%CI: 0.008-1.959). The mean value of TyG Index+SD was 4.8872 + 0.4230 at severe foot ulcers.
Conclusion: TyG index is not a predictive factor for the severity of diabetic foot ulcers in type 2 DM patients at the Diabetic Foot Clinic of Ulin Hospital Banjarmasin (p>0.05).

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Author Biographies

  • Istiqomah, Department of Internal Medicine, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, Indonesia

    -

  • Fauzia Noor Liani, Division of Endocrine Metabolism, Department of Internal Medicine, Ulin Hospital Banjarmasin, Indonesia

    -

  • Mohammad Bakhriansyah, Division of Pharmacology, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, Indonesia

    -

References

1. Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y. Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis†. Vol. 49, Annals of Medicine. Taylor and Francis Ltd; 2017. p. 106–16.

2. Bashmakov YK, Assaad-Khalil S, Petyaev IM. Resveratrol may be beneficial in treatment of diabetic foot syndrome. Med Hypotheses. 2011 Sep;77(3):364–7.

3. Hill MA, Yang Y, Zhang L, Sun Z, Jia G, Parrish AR, et al. Insulin resistance, cardiovascular stiffening and cardiovascular disease. Vol. 119, Metabolism: Clinical and Experimental. W.B. Saunders; 2021.

4. Rastogi A, Goyal G, Kesavan R, Bal A, Kumar H, Mangalanadanam, et al. Long term outcomes

after incident diabetic foot ulcer: Multicenter large cohort prospective study (EDI-FOCUS investigators) epidemiology of diabetic foot complications study: Epidemiology of diabetic foot complications study. Diabetes Res Clin Pract. 2020 Apr 1;162.

5. Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuñiga FA. Association between insulin resistance and the development of cardiovascular disease. Vol. 17, Cardiovascular Diabetology. BioMed Central Ltd.; 2018.

6. Lee SB, Ahn CW, Lee BK, Kang S, Nam JS, You JH, et al. Association between triglyceride glucose index and arterial stiffness in Korean adults. Cardiovasc Diabetol. 2018 Mar 21;17(1).

7. Tao LC, Xu J ni, Wang T ting, Hua F, Li JJ. Triglyceride-glucose index as a marker in cardiovascular diseases: landscape and limitations. Vol. 21, Cardiovascular Diabetology. BioMed Central Ltd; 2022.

8. Zhang X, Chen W, Wang X, Wu J, Shi W, Wang Wencheng people X, et al. Association between

Triglyceride glucose index and severity of diabetic foot ulcers in type2 diabetes melitus. J

Foot Ankle Res. 2023.

9. Shah P, Inturi R, Anne D, Jadhav D, Viswambharan V, Khadilkar R, et al. Wagner’s Classification as a Tool for Treating Diabetic Foot Ulcers: Our Observations at a Suburban Teaching Hospital. Cureus. 2022 Jan 23

10. Salazar, J., Bermúdez, V., Calvo, M., Olivar, L. C., Luzardo, E., Navarro, C.,Rojas, J. Optimal cutoff

for the evaluation of insulin resistance through triglyceride-glucose index: A cross- sectional

study in a Venezuelan population. 2017.

11. McDermott K, Fang M, Boulton A, Selvin E, Hicks C. Etiology, Epidemiology, and Disparities in the Burden of Diabetic Foot Ulcers.Diabetes Care 2023;46(1):209–221

12. Hicks CW, Canner JK, Mathiodakis N, Lippincott C, Sherman RL, Abularrage CJ. Incidence and

Risk Facctors associated with ulcer recurrent among patients with diabetic foot ulcers treated in a multidisciplinary setting J. Surg Res 2020;246:243-250

13. Rossboth S, Lechleitner M, Oberaigner W. Risk factor for diabetic foot complication in type 2 diabetes-A Systematic review. Endocrinol Diabetes Metab 2020;4:e00175

14. Detty Ade U, The Characteristics of Diabetic Ulcer in Patients with Diabetes Mellitus, jiksh Vol.11 No.1 Juni 2020

15. Zamaun N, Kanang I, Imran M, Iskandar D, Amba EG. Karakteristik Penderita Ulkus Kaki Diabetik. Fakumi Medical Journal: Jurnal Mahasiswa Kedokteran Vol.04 No.04 (April, 2024) E-ISSN:

2808-9146

16. Jalilian M, Sarbarzeh PA, Oubari S. Factors Related to Severity of Diabetic Foot Ulcer: A Systematic Review. Metabolic Syndrome and Obesity, 2020, 1835-1842.

17. Sutkowska E, Sutkowski E, Sokołowski M, Franek E, Dragan S. Distribution of the Highest Plantar Pressure Regions in Patients with Diabetes and Its Association with Peripheral Neuropathy, Gender, Age, and BMI: One Centre Study. Hindawi Journal of Diabetes Research Volume 2019.

18. Nan Xia1, Morteza A, Yang F, Cao H, Wang A. Review of the role of cigarette smoking in diabetic foot. J Diabetes Investig 2019; 10: 202–215.

19. AbdElrahman A. Association Between Smoking and Foot Ulcer among Patients with Diabetes

Mellitus, Wad Medani, Sudan. 2021. Sudan Journal of Medical Sciences, vol. 16, Issue no. 4,pages 450–463.

20. Safari, F. K., Budiharto, I. & Fahdi, F. K. Hubungan Lama Menderita Diabetes Melitus dengan

Kejadian Luka Kaki Berulang di Klinik PKU Muhammadiyah Kitamura Pontianak. Indones. J. Heal. Sci. Volume 15, 1–6 (2023)

21. Ramadani, A. P. et al. Karakteristik Pasien Diabetes Mellitus Tipe 2 dengan Ulkus Diabetik

dan Non Ulkus Diabetik di Rumah Sakit Ibnu Sina Makassar Tahun 2019 - 2021. J. Pendidik.

22. Balakrishnan R, Nagarajan V. Comparative study of insulin with oral antidiabetic drug in Type 2 Diabetik wound healing. Int J Acad Med Pharm. 2023; 5 (2); 394-396

23. O’Dell B, Rothenberg G, Holmes C, Priesand S, Stout K, Brandt E, Brian. The impact of statin

therapy on the healing of diabetic foot ulcers: a case–control series Clinical Diabetes and

Endocrinology (2024) 10:19

24. Nassaji M, Ghorbani R, Shkofte HS. Previous Atorvastatin Treatment and Risk of Diabetic Foot

Infection in Adult Patients: A Case control Study. Wounds. 2017;29(7):196–201

25. Jia H, Wang X, Cheng J. Knowledge, Attitudes, and Practices Associated With Diabetic Foot

Prevention Among Rural Adults With Diabetes in North China. Front Public Health. 2022;10:876105.

26. Liberty IA, Kodim N, Sartika RA, Trihandini I, Zulkarnai, Pane M et al. Triglyceride/Glucose

Index (TyG Index) as a marker of glucose status conversion among reproductive-aged women

in Jakarta, Indonesia: The Bogor cohort study (2011-2016). Diabetes &Metabolic Syndrome: Clinical Research & Reviews 15. 2021; 10228

27. Liberty IA, Putri NK. Association Between Triglyceride-Glucose Index (TyG Index) and Type 2 Diabetes Mellitus: A Systematic Review. Epidemiology Biostatistics and Public Health -

2020, Volume 17, Number 1

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Published

01-12-2025

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Original Article

How to Cite

1.
Istiqomah, Fauzia Noor Liani, Mohammad Bakhriansyah. Triglyceride-Glucose Index as a Predictor of DiabeticFoot Ulcer Severity in Type 2 Diabetes Mellitus:Cross-Sectional Study. InaJEMD [Internet]. 2025 Dec. 1 [cited 2026 Apr. 12];2(2):8-16. Available from: https://inajemd.pbperkeni.or.id/index.php/journal/article/view/vol2no2-2

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