Abstract

Complications from diabetes mellitus can compromise a driver's ability to safely operate a motor vehicle, yet little is known about whether euglycemia predicts normal driving risks among adults with diabetes. We studied the association between glycosylated hemoglobin (HbA1c) and the risk of a motor vehicle crash using a population-based case control analysis. We identified consecutive drivers reported to vehicle licensing authorities between January 1, 2005 to January 1, 2007 who had a diagnosis of diabetes mellitus and a HbA1c documented. The risk of a crash was calculated taking into account potential confounders including blood glucose monitoring, complications, and treatments. A total of 57 patients were involved in a crash and 738 were not involved in a crash. The mean HbA1c was lower for those in a crash than controls (7.4% versus 7.9%, unpaired t-test, p = 0.019), equal to a 26% increase in the relative risk of a crash for each 1% reduction in HbA1c (odds ratio = 1.26, 95% confidence interval 1.03-1.54). The trend was evident across the range of HbA1c values and persisted after adjustment for measured confounders (odds ratio = 1.25, 95% confidence interval 1.02-1.55). The two other significant risk factors for a crash were a history of severe hypoglycemia requiring outside assistance (odds ratio = 4.07, 95% confidence interval 2.35-7.04) and later age at diabetes diagnosis (odds ratio per decade = 1.29, 95% confidence interval 1.07-1.57). In this selected population, tighter glycemic control, as measured by the HbA1c, is associated with an increased risk of a motor vehicle crash.

Highlights

  • Diabetic patients account for substantial amounts of driving

  • If diabetic drivers were identical to average American adults, the baseline risk of a serious crash would be about one in 20 per year [6]. This number would amount to about five diabetic drivers killed and another 50 incapacitated each day from motor vehicle crashes in the United States

  • Candidates were identified from mandatory annual reviews submitted by drivers who held commercial licenses or mandatory reports submitted in the aftermath of a documented motor vehicle crash

Read more

Summary

Introduction

At a population disease prevalence of 5% to 7% for this diagnosis, general mobility statistics would suggest that diabetic patients drive about 250 million miles during the average day in the United States [1,2]. Such distances are extraordinary— greater than traveling from the earth to the sun and back [3]. Type 1 diabetes occurs when the body’s immune system prevents the production of insulin, the hormone that controls blood glucose It accounts for 5%–10% of diabetes cases in adults and the vast majority of cases in childhood. As obesity rates rise worldwide, it is expected that the prevalence of type 2 diabetes will increase

Methods
Results
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call