Association Between Triglyceride Level and Glycemic Control Among Insulin-Treated Patients With Type 2 Diabetes

CONTEXT: Elevated blood triglyceride levels are known to increase the risks of diabetes and prediabetes. However, it is still unclear whether elevated triglyceride levels are associated with inadequate glycemic control in patients with type 2 diabetes mellitus. OBJECTIVE: To investigate the association between elevated triglyceride levels and inadequate glycemic control among insulin-treated patients with type 2 diabetes mellitus. DESIGN, SETTING, AND PATIENTS: We recruited 20,108 patients with type 2 diabetes mellitus who were treated with a sufficient dose of insulin. These patients were from the 2013 China National HbA1c Surveillance System study conducted in Mainland China. Multivariate logistic regressions were used to assess the association of triglyceride level with inadequate glycemic control. RESULTS: Overall, 56.0% of the subjects had elevated triglyceride levels (≥1.70 mmol/L); prevalence of HbA1c ≥7.0% (53 mmol/mol) and ≥6.5% (48 mmol/mol) was 67.2% and 83.4%, respectively. The adjusted ORs (95% CIs) of HbA1c ≥7.0% were 1.06 (0.98, 1.15), 1.35 (1.23, 1.48), and 3.12 (2.76, 3.53) for those with triglyceride levels in ranges of 1.70 to 2.29, 2.30 to 3.39, and ≥3.40 mmol/L, respectively, compared with those with triglyceride levels of <1.70 mmol/L. There was a similar association between triglyceride levels and HbA1c ≥6.5%. This association was confirmed by subgroup analyses. There was also a strong nonlinear dose-response relationship between triglyceride level and inadequate glycemic control. CONCLUSIONS: Elevated triglyceride levels were strongly associated with inadequate glycemic control; thus, suppressing triglyceride levels may attain more optimal glycemic control in patients with type 2 diabetes mellitus.