title: Many diabetic patients with recurrent severe hypoglycemias hold a valid driving license. A community-based study in insulin-treated patients with diabetes.
abstract: OBJECTIVE
  We studied retrospectively the current driving license status in insulin-treated diabetic patients, who had severe hypoglycemia (SH) within an observation period of one year and who lived in two Finnish communities.
  
  
  METHODS
  The episodes of SH were identified from local ambulance registers, the databases of local health care units and from patient questionnaires in 680 insulin-treated diabetic patients. The data on current driving licenses were obtained from local police authorities.
  
  
  RESULTS
  Of type 1 and type 2 insulin-treated diabetic patients 31.0 and 12.3 percent, respectively, had at least one self-reported SH, whereas 53 (7.8%) of them reported even three or more episodes of SH. Of insulin-treated patients with clustering of SH 68 percent still held a driving license, and 21percent of them held even a license for commercial vehicles up to 3.5 tons.
  
  
  CONCLUSIONS
  Recurrent episodes of SH occur in a minority of insulin-treated diabetic patients. However, two thirds of them still held a valid driving license even for commercial vehicles, which violates the medical standards for diabetes and driving.
authors.affiliation: Nurmijarvi Health Centre, Nurmijarvi, Finland. mikko.honkasalo@nurmijarvi.fi
authors.forename: Mikko
authors.initials: M
authors.lastname: Honkasalo
authors.forename: Outi
authors.initials: O
authors.lastname: Elonheimo
authors.forename: Timo
authors.initials: T
authors.lastname: Sane
mesh_terms: D000368:Aged; D001334:Automobile Driving / Q000331:legislation & jurisprudence*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology* / Q000209:etiology; D007328:Insulin / Q000627:therapeutic use*; D008004:Licensure / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D007328:Insulin