Fear of driving license withdrawal in patients with insulin-treated diabetes mellitus negatively influences their decision to report severe hypoglycemic events to physicians.
BACKGROUND
Under current European Union legislation, two severe hypoglycemic events within 12 months is grounds for driving license withdrawal. The aim of the study reported here was to determine whether fear of such a withdrawal could lead to patients concealing severe hypoglycemia from physicians, which could negatively impact further treatment decisions.


METHODS
A total of 663 patients with insulin-treated diabetes were anonymously surveyed about whether they would conceal severe hypoglycemic events from their physicians, if revealing them could result in driving license withdrawal. This investigation utilized an adapted and expanded questionnaire by Graveling et al.


RESULTS
Of all diabetic patients surveyed, 26.17% would most likely not report hypoglycemia, and 25.86% were undecided. In a group of patients with type 1 diabetes, 31.83% would likely not report hypoglycemic events, and 25.06% were undecided. The patients least likely to report severe hypoglycemic events were those who indicated that vehicles were partly essential for work, and who also had more than two hypoglycemic events monthly.


CONCLUSIONS
A considerable percentage of diabetic patients would likely conceal severe hypoglycemic events from their physicians due to fear of driving license withdrawal. Patient failure to report severe hypoglycemic events can potentially lead to physicians being misinformed regarding the patient's condition, which could lead to inadequate monitoring and treatment.
Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Jan
J
Brož
Institute of Computer Science of the Academy of Sciences of the Czech Republic, Czech Technical University in Prague, Prague, Czech Republic ; Czech Institute of Informatics, Robotics, and Cybernetics, Czech Technical University in Prague, Prague, Czech Republic.
Marek
M
Brabec
Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Denisa
D
Janíčková Žďárská
Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Zuzana
Z
Fedáková
Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Lucie
L
Hoskovcová
Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Jee Young
JY
You
Diabetes and Metabolism Center, Juh Polyclinic, Kosice, Slovakia.
Viera
V
Doničová
Institute of Lifelong Learning, Mendel University in Brno, Brno, Czech Republic.
Petr
P
Hlaďo
Department of Endocrinology, Diabetes and Metabolic Diseases, Dubrava University Hospital, Zagreb, Croatia.
Dario
D
Rahelić
Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Milan
M
Kvapil
Center for Research on Diabetes, Metabolism and Nutrition, Second Department of Internal Medicine, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
Jan
J
Polák
education; hypoglycemia; law; type 1 diabetes