Abstract
Driving is a complex process that places considerable demands on cognitive and physical functions. Many complications of diabetes can potentially impair driving performance, including those affecting vision, cognition and peripheral neural function. Hypoglycemia is a common side-effect of insulin and sulfonylurea therapy, impairing many cognitive domains necessary for safe driving performance. Driving simulator studies have demonstrated how driving performance deteriorates during hypoglycemia. Driving behavior that may predispose to hypoglycemia while driving is examined. Studies examining the risk of road traffic accidents in people with insulin-treated diabetes have produced conflicting results, but the potential risk of hypoglycemia-related road traffic accidents has led to many countries imposing restrictions on the type and duration of driving licenses that can be issued to drivers with diabetes. Guidance that promotes safe driving practice has been provided for drivers with insulin-treated diabetes, which is the group principally addressed in this review.
Highlights
Driving has important business and recreational roles for transport in most countries, allowing people to travel to and from work, pursue their employment, and undertake multiple social and domestic activities
The present review focuses mainly on drivers who require insulin treatment for their diabetes
One reason why many studies failed to show a significant difference in road traffic accidents (RTAs) rates at a population level between people at risk of hypoglycemia and the general population with driving licenses is that many countries impose restrictions on drivers with insulin-treated diabetes and remove those who are at high risk of having an accident
Summary
Background Driving has important business and recreational roles for transport in most countries, allowing people to travel to and from work, pursue their employment, and undertake multiple social and domestic activities. During simulation studies, driving per se required higher dextrose infusion rates to maintain normoglycemia compared to passively watching a driving video; this increased metabolic demand in drivers may risk promoting hypoglycemia, if their blood glucose is
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