For many people, seeing “normal” numbers on a blood test brings instant relief. Fasting blood sugar looks fine. HbA1c, which reflects average blood sugar levels over the last three months, is also within range. Yet, fatigue persists, weight refuses to budge, and cholesterol levels slowly creep up. According to experts, this mismatch may point towards insulin resistance – an early metabolic issue that often slips past routine blood tests. In a recent Instagram post, nutritionist Pooja Makhija sheds light on a lesser-known but increasingly important metabolic marker that can help detect insulin resistance even when conventional reports appear “normal.”
“Your fasting sugar levels are normal, your three-monthly average HbA1c is normal, but insulin resistance seems to be there,” Makhija says, adding that testing insulin resistance directly can be expensive and is often not included in standard health packages.
Insulin resistance occurs when the body's cells stop responding effectively to insulin, forcing the pancreas to produce more of the hormone to keep blood sugar levels in check. In its early stages, glucose levels may still appear normal, making the condition difficult to detect.
Although gold-standard tests exist for diagnosing insulin resistance, they are costly and rarely part of routine health check-ups. This is where the triglyceride–glucose ratio, or TyG index, comes in — something Makhija refers to as a “simple hack” for assessing metabolic risk.
According to Makhija, the TyG index offers deeper insight into how the body manages fuel by combining two commonly measured fasting parameters: blood glucose and triglycerides.
“When fasting triglycerides and fasting blood sugar levels rise together, they are indicating something more than just sugar alone. They are indicating insulin resistance,” she explains.
Makhija points out that insulin resistance triggers two key early changes. First, the liver begins producing excess glucose even when the body does not need it. Second, triglycerides derived from fat start leaking into the bloodstream.
“Your TyG index captures both failures at once,” she adds, describing it as a marker that reflects deeper metabolic stress rather than a fleeting blood sugar snapshot.
She further cites recent studies showing that the TyG index performs comparably to gold-standard methods used to assess insulin resistance. It can also help predict future risks of cardiovascular disease and type 2 diabetes, even before HbA1c levels begin to rise.
Calculating the TyG index, Makhija explains in the caption of her post, is simple. It uses the following formula and fasting blood levels expressed in mg/dL: TyG index = ln [ (Triglycerides × Fasting Glucose) ÷ 2 ].
All you need is a calculator that can compute the natural logarithm, along with fasting glucose and fasting triglyceride values.
A TyG index below 8.5 suggests lower metabolic risk. Values between 8.5 and 9.0 indicate emerging insulin resistance, while scores above 9.0 point to a higher risk of insulin resistance, type 2 diabetes and cardiovascular disease.
According to Makhija, certain groups may benefit the most from tracking the TyG index. These include perimenopausal or postmenopausal women showing signs of insulin resistance, such as pigmentation or PCOS despite “normal” test results, people who wake up exhausted despite adequate sleep, and individuals struggling with stubborn fat or elevated triglyceride levels.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your doctor for more information. NDTV does not claim responsibility for this information.
