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Earlier studies have found connections between this blood test and individual diabetic complications. However, most were snapshot studies looking at one point in time rather than tracking people over many years. A 2019 review of 26 studies found that people with one complication often develop others.

This study adds to that knowledge by following people for 13 years and showing that the blood test score predicts not just first complications but also the risk of developing multiple complications. The finding that the test remained predictive even after accounting for lifestyle factors fills an important gap. However, whether using this test in clinical practice actually improves patient outcomes remains unknown.

This study has moderate confidence. Strong points include nearly 20,000 participants tracked for 13 years. Researchers accounted for lifestyle factors like diet and exercise. They found a clear pattern between higher levels and greater complication risk.

However, important limits exist. This study shows a connection but can't prove cause and effect. Complications were identified from hospital records, which may miss some cases. Participants were healthier than average and mostly of European background, so results may differ for other groups. Finally, we don't know if using this test to guide treatment actually helps patients.

Higher combined blood sugar and fat levels may predict greater risk of diabetic complications like nerve damage, eye problems, and kidney issues

The link appears strongest for nerve damage, with more modest connections to eye and kidney problems

Results may help doctors identify who needs closer monitoring, but more research is needed to know if this test improves care beyond current methods

A simple blood test combining sugar and fat levels may help spot who's at higher risk for complications

The test appears most useful for predicting nerve damage and multiple complications occurring together

The connection held even after accounting for lifestyle factors, suggesting it captures something beyond standard tests

Combined with genetic testing, it might help personalize prevention strategies for different people

This study looked at a blood test score, not a treatment. The score combines fasting blood sugar and triglyceride levels to estimate insulin resistance. Researchers measured this at the study's start and then tracked who developed complications.

The study also looked at genetic risk using DNA testing. People were grouped by low, medium, or high genetic risk for diabetes. Researchers then examined whether combining the blood test score with genetic risk could better identify who's most likely to develop complications.

Triglyceride measurement, Blood glucose measurement, Insulin resistance, Risk assessment, Genetic susceptibility, Polygenic risk score

Yuan X, Peng M, Shi X, Yang D, Wang F, Hou C, Xu G. Triglyceride-glucose index, genetic susceptibility, and trajectory of microvascular multimorbidity in type 2 diabetes. Sci Rep. 2026;16:8230. doi:10.1038/s41598-026-39777-w

Over 13 years, about 30% of participants developed at least one complication. Higher scores on the blood test were linked to higher complication risk. The strongest link was for nerve damage, followed by eye and kidney problems. People with both high blood test scores and high genetic risk had the greatest overall risk of developing complications.

Shows a link but doesn't prove cause and effect

Mostly European ancestry limits broader applicability

Unclear if using this test improves outcomes

Combined blood sugar and triglyceride levels may help predict diabetic complication risk.

This study shows a link but can't prove that high triglyceride-glucose levels directly cause complications. Complications were tracked using hospital records, which may miss milder cases. Participants were healthier than the general population and mostly of European background, so results may not apply to everyone. The blood test is an estimate of insulin resistance rather than a direct measurement. We don't yet know what levels should trigger action or whether using this test improves patient outcomes.

Multiple complications → ↑ (moderate link)

American Diabetes Association, Diabetes Care, 2020

ADA Standards of Care in Diabetes 2020: Microvascular complications and foot care

Mayo Clinic: Diabetic neuropathy - Symptoms and causes

Researchers analyzed data from nearly 20,000 adults with type 2 diabetes in the UK Biobank study. None had complications when the study began. They were tracked for about 13 years to see who developed eye, kidney, or nerve problems.

The study calculated a score combining fasting blood sugar and triglyceride levels. Researchers then looked at who developed complications over time. They accounted for factors like age, lifestyle, blood pressure, and diabetes medications to ensure the connection wasn't due to other causes.

Liu et al., Journal of Diabetes Investigation, 2021

Association between the triglyceride-glucose index and diabetic nephropathy in patients with type 2 diabetes

Correlations among diabetic microvascular complications: A systematic review and meta-analysis

High blood sugar and triglycerides together may predict diabetic complications

Researchers tracked nearly 20,000 people with type 2 diabetes for about 13 years. They looked at a simple blood test that combines blood sugar and fat levels. Higher levels on this test were linked to increased risk of serious diabetes complications.

People with the highest levels had 19% more risk for their first complication. They also had 38% more risk for developing multiple complications at once. The link was strongest for nerve damage. When combined with genetic testing, this simple blood test may help doctors identify who needs closer monitoring.

This shows a link but doesn't prove cause and effect—we don't know if lowering these levels reduces complications

We don't yet know what levels are concerning or if using this test actually improves patient outcomes

The study mostly included people of European background, so results may not fully apply to other groups

Nearly 20,000 adults with type 2 diabetes tracked for 13 years in the UK

Adults with type 2 diabetes, especially those aged 40-69 without existing complications

Researchers tracked nearly 20,000 people with type 2 diabetes for about 13 years. They looked at a simple blood test that combines blood sugar and fat levels. Higher levels on this test were linked to increased risk of serious diabetes complications.
People with the highest levels had 19% more risk for their first complication. They also had 38% more risk for developing multiple complications at once. The link was strongest for nerve damage. When combined with genetic testing, this simple blood test may help doctors identify who needs closer monitoring.

High blood sugar and triglycerides together may predict diabetic complications

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Journal Reference

Sources

ADA Standards of Care in Diabetes 2020: Microvascular complications and foot care

Mayo Clinic: Diabetic neuropathy - Symptoms and causes

Association between the triglyceride-glucose index and diabetic nephropathy in patients with type 2 diabetes

Correlations among diabetic microvascular complications: A systematic review and meta-analysis

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