The presence of microvascular complications is associated with a poor evolution of metabolic control in patients with type 1 diabetes mellitus.

OBJECTIVE: To report the evolution of metabolic control and to assess the clinical and metabolic factors associated with the presence of microvascular complications in patients with type 1 diabetes mellitus (T1DM). MATERIAL AND METHODS: This was a retrospective, observational study analysing clinical, laboratory, and therapeutic data from a registry of patients with T1DM created in 2010. RESULTS: Data recorded from 586 patients (males: 50.2%; mean age: 36.1±13.5 years; T1DM duration: 18.0±12.1 years) followed for a mean of 6.0±3.1 years were assessed, and 8133 HbA1c levels (13.2±7.6 measurements/patient) were analysed, with a mean evolutionary HbA1c of 7.9%±1.2%. The mean annual HbA1c level gradually improved from 8.6%±1.6% in 2010 to 7.5%±1.4% in 2019, with 34.3% and 69.0% of patients having HbA1c levels ≤7% and ≤8% respectively. Patients with T1DM duration of <10 years and ≥20 years, non-smokers, CSII users, and those using the insulin/carbohydrate ratio had better current and evolutionary HbA1c levels. The presence of microvascular complications was independently associated with T1DM lasting ≥20 years, the presence of HBP, and evolutionary HbA1c≥7.0%. CONCLUSION: A progressive but still inadequate improvement in metabolic control over 10 years was seen in patients with T1DM. Poor metabolic control (mean HbA1c over 10 years ≥7%) was independently associated with the presence of microvascular complications.

Use of Data Mining Techniques for the Prediction of Surface Roughness of Printed Parts in Polylactic Acid (PLA) by Fused Deposition Modeling (FDM): A Practical Application in Frame Glasses Manufacturing.

In the present work, ten data mining algorithms have been used to generate models capable of predicting the surface roughness of parts printed on polylactic acid (PLA) by using fused deposition modeling (FDM). The models have been trained using experimental data measured on 27 horizontal (XY) and 27 vertical (XZ) specimens, printed using different values for the parameters studied (layer height, extrusion temperature, print speed, print acceleration and flow). The models generated by multilayer perceptron (MLP) and logistic model trees (LMT) have obtained the best results in a cross-validation. Although it does not obtain such optimal results, the J48 algorithm (C4.5) allows the generation of models in the form of a decision tree. These trees permit to determine which print parameters have an influence on the surface roughness. For XY specimens, the surface roughness measured in the direction parallel to the extrusion path (Ra,0,XY ) depends on the flow, the print temperature and the layer height; in the direction perpendicular to the extrusion path, the surface roughness (Ra,90,XY) depends only on the flow. For XZ specimens, the surface roughness measured in the direction parallel to the extrusion path (Ra,0,XZ) depends only on the print speed; in the direction perpendicular to the extrusion path (Ra,90,XZ), it depends on the layer height and the extrusion temperature. According to the study carried out, the most suitable set up provides values of Ra,0,XY, Ra,90,XY, Ra,0,XZ and Ra,90,XZ equal to 0.46, 1.18, 0.45 and 11.54, respectively. A practical application of this work is the manufacture of PLA frame glasses using FDM.

Web-based telemedicine system is useful for monitoring glucose control in pregnant women with diabetes.

OBJECTIVE: The aim of this study was to examine the impact of a Web-based telemedicine system for monitoring glucose control in pregnant women with diabetes on healthcare visits, metabolic control, and pregnancy outcomes. SUBJECTS AND METHODS: A prospective, single-center, interventional study with two parallel groups was performed in Puerto Real University Hospital (Cadiz, Spain). Women were assigned to two different glucose monitoring groups: the control group (CG), which was managed only by follow-ups with the Gestational Diabetes Unit (GDU), and the telemedicine group (TMG), which was monitored by both more spaced GDU visits and a Web-based telemedicine system. The number of healthcare visits, degree of metabolic control, and maternal and neonatal outcomes were evaluated. RESULTS: One hundred four pregnant women with diabetes (77 with gestational diabetes, 16 with type 1 diabetes, and 11 with type 2 diabetes) were included in the TMG (n=40) or in the CG (n=64). There were no significant differences in mean glycated hemoglobin level during pregnancy or after delivery, despite a significantly lower number of visits to the GDU (3.2±2.3 vs. 5.9±2.3 visits; P<0.001), nurse educator (1.7±1.3 vs. 3.0±1.7 visits; P<0.001), and general practitioner (3.7±2.0 vs. 4.9±2.8 visits; P<0.034) in the TMG. There were no significant differences between groups in maternal or neonatal outcomes. CONCLUSIONS: A Web-based telemedicine system can be a useful tool facilitating the management of pregnant diabetes patients, as a complement to conventional outpatient clinic visits.

La rotación rural: un reto y una oportunidad para mejorar / Rural rotation: a challenge and an opportunity for improvement

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