Diabetes screening tests for South Asians
Are there better tests than A1c to assess diabetes control? What about the Triglyceride-glucose ratio?
South Asians experience a more rapid decline in insulin sensitivity and faster increases in fasting glucose compared to white individuals, This accelerated metabolic deterioration suggests that earlier and more intensive screening may be warranted in this population. Some experts propose extending the HbA1c range for high diabetes risk from 6.0-6.4% to 5.7-6.4% in South Asians, or repeating glycemic testing at 6-month rather than 12-month intervals.There are 3 other ways to find early insulin resistance 1. The 2-hour oral glucose tolerance test (OGTT) is the most sensitive test for detecting early pancreatic failure and insulin resistance in South Asians before HbA1c becomes abnormal . But it is tedious to do 2. The triglyceride-glucose (Tg/Glu) ratio at cut off of > 1.19 ( which means if your ratio is > 1.19) demonstrates high sensitivity (80%) and specificity (79%) for detecting insulin resistance in normoglycemic South Asian males. It can be used before A1C to predict Insulin resistance 3. The TG/HDL ratio demonstrates moderate sensitivity (52-86%) and specificity (61-98%) for detecting insulin resistance, but shows significant ethnic and sex-specific limitations in South Asians, particularly in South Asian women where it performs poorly. SO we would not recommend that