Glycaemic Control of Type 1 Diabetes Mellitus Paediatric Patients before and after the Use of Telephonic Reinforcement: A Prospective Interventional Study at a Tertiary Care Hospital, Western India

Introduction: Type 1 Diabetes Mellitus (T1DM) is one of the most common paediatric endocrine illnesses. It is a chronic condition that involves regular administration of insulin, meal planning, strict adherence to physical activity and home-based sugar monitoring. Regular follow-up is essential to prevent short-term and long-term complications. Telemedicine has been extensively used in the management of multiple chronic conditions in adults. However, there are limited studies showing the impact of telemedicine in T1DM paediatric patients in the Indian population. Aim: To compare the glycaemic control in paediatric T1DM patients, before and after the use of telephonic reinforcement. Materials and Methods: A prospective, interventional study was conducted at Shree Krishna Hospital, Karamsad, Gujarat, India with no sub-specialty clinic. The duration of the study was one year and five months, from November 2017 to April 2019. Paediatric patients upto the age of 18 years, diagnosed with T1DM (by paediatricians/physicians) were included in the study. The records of 64 patients were traced, 27 were enrolled prospectively for the study (who could be contacted and consented to the present study). The baseline weight, height, age, duration of T1DM, insulin dosage and baseline Glycosylated Haemoglobin (HbA1c) were recorded. Majority of the patients 24 (89.4%) from rural area belonged to lower socioeconomic class, belonging to lower socioeconomic class. After receiving due consent, the patients/parents were provided telephonic reinforcement by a paediatrician to ensure regular sugar monitoring, solve queries of parents and to ensure regular follow-up. The clinical profile and parameters were repeated at three monthly intervals and compared. A paired t-test was used with a p-value=0.05 as a cut-off to compare data before and after intervention. Results: The mean and median ages of the study participants at diagnosis were found to be 8.9 years and 10.5 years, respectively. Average duration of T1DM was four years. On telephone, three things were reinforced: 1) To take insulin regularly as advised; 2) To come for follow-up regularly and 3) If any difficulties faced by them while taking insulin or coming for follow-up then to contact us. The patients were followed-up as per routine, diabetic care protocol every three months and value of HbA1c was reduced significantly during follow-up. The (p-value<0.001) showed a significant difference after telephonic reinforcement. Conclusion: Telephonic reinforcement improves control of T1DM, by improving laboratory parameters and compliance with regular follow-up

From measurements to knowledge:online quality monitoring and smart manufacturing

Abstract The purpose of this study was to develop an innovative supervisor system to assist the operators in an industrial manufacturing process to help discover new alternative solutions for improving both the products and the manufacturing process. This paper presents a solution for integrating different types of statistical modelling methods for a usable industrial application in quality monitoring. The two case studies demonstrating the usability of the tool were selected from a steel industry with different needs for knowledge presentation. The usability of the quality monitoring tool was tested in both case studies, both offline and online