title: Road traffic accident risk in patients with diabetes mellitus receiving blood glucose-lowering drugs. Prospective follow-up study.
abstract: OBJECTIVE
  To investigate, at a national level, whether patients using insulin or oral glucose-lowering agents had an increased risk of road traffic accidents compared with non-users.
  
  
  METHODS
  All Norwegians aged 18-69 years (3.1 million) were followed from April 2004 until September 2006. Information on drug prescriptions, road traffic accidents and emigration/death was obtained from the following population-based registries: the Prescription Database, the Road Accident Registry and the Central Population Registry. The exposure period was the time from the first prescription of insulin or oral glucose-lowering agent during the study period. The incidence of accidents in the exposed person-time was compared with the incidence of accidents in the unexposed person-time by standardized incidence ratio (SIR).
  
  
  RESULTS
  During the study period, 20 494 road traffic accidents with personal injuries were registered in Norway. One hundred and eighty-three accidents were registered for insulin users not taking oral glucose-lowering agents and 219 for users of oral blood glucose-lowering drugs without insulin. The SIR (95% confidence interval) for all ages and both genders combined were: insulin 1.4 (1.2-1.6), oral glucose-lowering agents 1.2 (1.0-1.3) and users of drugs for peptic ulcer and gastro-oesophageal reflux disease (negative comparators) 1.3 (1.2-1.4). The highest SIRs were found among the youngest insulin users (18-34 years old).
  
  
  CONCLUSIONS
  A slightly increased risk of being involved in a road traffic accident was observed for drivers prescribed insulin, while no increased risk was observed for drivers prescribed oral glucose-lowering agents. The increased risk observed for insulin users was similar to that observed for users of drugs for peptic ulcer and gastro-oesophageal reflux disease.
authors.affiliation: Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Skurtveit
authors.forename: H
authors.initials: H
authors.lastname: Strøm
authors.forename: T
authors.initials: T
authors.lastname: Skrivarhaug
authors.forename: J
authors.initials: J
authors.lastname: Mørland
authors.forename: J G
authors.initials: JG
authors.lastname: Bramness
authors.forename: A
authors.initials: A
authors.lastname: Engeland
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007328:Insulin / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin