Elevated TyG Index in Early Pregnancy Predicts Gestational Diabetes Risk: Study

A new study published in the journal of Frontiers in Endocrinology revealed that higher triglyceride-glucose (TyG) indices during the first and second trimesters, as well as a progressive rise in TyG levels throughout pregnancy, are independent risk factors for gestational diabetes mellitus (GDM). These findings suggest that monitoring the TyG index may help identify women at increased risk, enabling earlier prevention and management of GDM.

Gestational diabetes mellitus increases the likelihood of pregnancy complications, including high birth weight, preterm delivery, and cesarean section, while also raising the long-term risk of type 2 diabetes in both mothers and their children. Despite its growing prevalence, reliable methods for predicting GDM before symptoms appear remain limited.

Thus, this prospective cohort study involving 870 pregnant women investigated whether TyG index levels measured during the first and second trimesters, along with the percentage increase in TyG levels between these stages, could predict the onset of gestational diabetes. Among the study participants, 119 women developed gestational diabetes, representing an incidence rate of 13.68%. This research initially screened potential risk factors using univariate Cox regression analysis before constructing a multivariate Cox proportional hazards model to evaluate the independent relationship between TyG measurements and GDM risk.

After adjusting for established risk factors such as maternal age, body mass index (BMI), and family history of diabetes, the analysis revealed that higher TyG levels in early pregnancy, elevated TyG levels in mid-pregnancy, and a greater percentage increase in TyG levels during pregnancy were all independently associated with an increased likelihood of developing gestational diabetes. Notably, elevated TyG levels measured during mid-pregnancy emerged as the strongest predictor of GDM among the factors examined.

The findings illuminate the potential value of dynamic TyG monitoring rather than relying on a single measurement. Tracking changes in the TyG index throughout pregnancy may enable healthcare providers to identify women whose metabolic health is deteriorating before gestational diabetes is clinically diagnosed.

Overall, both elevated TyG indices during the first and second trimesters and progressive increases in the index throughout pregnancy have meaningful clinical value in assessing GDM risk. Incorporating TyG monitoring into routine prenatal care could support earlier intervention, closer surveillance of high-risk pregnancies, and more personalized management strategies.

Source:

Huang, G., Su, M., Li, C., Tan, H., Deng, J., & Chen, M. (2026). Triglyceride-glucose index as predictor of gestational diabetes mellitus in early pregnancy: a prospective cohort study. Frontiers in Endocrinology, 17, 1875641. https://doi.org/10.3389/fendo.2026.1875641