Blue Index—The Diabetes Health Score

Aim: To evaluate and monitor quality of diabetes care in a single risk score format BLUE INDEX (BI).

Design and Method: We assessed overall health of patients with T2DM based on 10 parameters - 3 goals (A1c, BP, lipids), 4 self-care parameters (diet, exercise, follow-up, habits), and 3 health parameters (general health, infection, hypoglycemia). We categorized each parameter into six grades and formulated BI with minimum score 0 and maximum 50. BI > 45 = excellent and > 40 is considered as favorable. BI < 35 = undesirable. We calculated BI for 100 patients with T2DM > 1 year and repeated it at 2nd visit (3 months) and 3rd visit (6 months). Patients were educated for importance of each parameter and their overall health score was discussed. At the end of 3rd visit improvement in each parameter was studied.

Result: 100 patients with T2DM > 1 year were studied and divided into 3 groups as per BI. Group A= BI < 35, Group B = BI 35-45 and Group C = BI > 45. At baseline there were 76, 17 and 7 patients in Group A, B and C respectively with mean BI =26 ±2. After 3 month - 33, 44 and 23 patients in Group A, B and C respectively with mean BI = 37±3 and after 6 months there were 21, 41 and 38 patients in Group A, B and C respectively with mean BI = 42±2. There was 61% improvement in BI over the 6 months.

Conclusion: The BI provides comprehensive, pragmatic and patient centered mean of assessing care in persons with diabetes. The main role is in clinical triage, helping identify high risk persons who need intensive clinical intervention.

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