Driving mishaps among individuals with type 1 diabetes: a prospective study.
OBJECTIVE
Hypoglycemia-related neuroglycopenia disrupts cognitive-motor functioning, which can impact driving safety. Retrospective studies suggest that drivers with type 1 diabetes experience more collisions and citations than their nondiabetic spouses. We present the first prospective data documenting the occurrence of apparent neuroglycopenia-related driving performance impairments.


METHODS
We completed the initial screening of 452 drivers from three geographically diverse centers who then reported monthly occurrences of driving "mishaps," including collisions, citations, losing control, automatic driving, someone else taking over driving, and moderate or severe hypoglycemia while driving.


RESULTS
Over 12 months, 52% of the drivers reported at least one hypoglycemia-related driving mishap and 5% reported six or more. These mishaps were related to mileage driven, history of severe hypoglycemia, and use of insulin pump therapy.


CONCLUSIONS
Many individuals with type 1 diabetes report hypoglycemia-related driving events. Clinicians should explore the recent experiences with hypoglycemia while driving and the risk of future events.
Cox
Daniel J
DJ
University of Virginia Health Sciences Center, Charlottesville, Virginia, USA. djc4f@virginia.edu
Ford
Derek
D
Gonder-Frederick
Linda
L
Clarke
William
W
Mazze
Roger
R
Weinger
Katie
K
Ritterband
Lee
L
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D001334:Automobile Driving / Q000706:statistics & numerical data; D001900:Boston; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005843:Geography; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology*; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D012449:Safety / Q000706:statistics & numerical data; D014768:Virginia
D007004:Hypoglycemic Agents; D007328:Insulin