Blue Index as a Comprehensive, Patient-centered Assessment of Care in Diabetic Patients

Assessment of diabetes health takes into account metabolic, nonmetabolic, and self-care measures like diet, exercise, follow-up, and habits. On the other hand, the index of complications includes the macro- and microvascular complications of diabetes along with foot complications. The Blue Index (BI) is a composite assessment of both diabetic health-related parameters and systemic complications stemming from diabetes. The present study aimed to evaluate the diabetes control status of the patients as a single index.

A prospective, observational study included a total of 100 adult diabetic patients in whom diabetic health status (DHS) and Komplications Score (KS) were assessed for cardiovascular/macrovascular, microvascular, and foot complications. The BI was calculated as a composite ratio, and measures were obtained at baseline, after 3 months, and at 6 months. Data were statistically analyzed.

Diabetic health status significantly increased at the 3rd month and the 6th month, respectively, compared to baseline (p = 0.000). KS significantly decreased at the 3rd month and the 6th month, respectively, compared to baseline measures (p = 0.000). The composite BI scores showed a steady increase of 9.62 at the 3rd month and 13.14 at the 6th month, respectively, compared to baseline. Assessing based on the duration of diabetes detection, the scores of DHS, KS, and BI showed similar changes. Assessing based on patients' gender, DHS was significantly higher in females at baseline compared to males, with gradual improvement in scores over time for both genders. Contrastingly, KS was significantly lower in males compared to females, with scores showing gradual decrement over the time frame, signifying improvement in complications. DHS was significantly correlated with the duration of diabetes detection (p = 0.001) and age (p = 0.01).

The BI is a simple tool that incorporates various parameters covering different aspects of diabetes care, including complications. It may be used not only by endocrinologists but also by all physicians as a tool to monitor and improve diabetic care.