Abstract
Insulins and some oral antidiabetics are considered to be driving-impairing medicines (DIM) and they belong to the Driving under the Influence of Drugs, alcohol, and medicines (DRUID) category I (minor influence on fitness to drive). The trend of antidiabetics use in Castilla y León from 2015 to 2018 is presented through a population-based registry study. Treatment duration with these medicines and the concomitant use of other DIMs were observed. An adjustment method was used with information from the drivers’ license census. For all calculations, age and gender were taken into account. 3.98% of the general population used at least one antidiabetic, as well as 2.92% of drivers. The consumption of antidiabetics in men was higher than in women (4.35% vs. 3.61%, p = 0.001), and the use increases with age, especially from 35–39 years to 75–79 years in men and 85–89 years in women. Antidiabetics were consumed chronically, specifically 100% in the case of insulins and 95% in the case of oral antidiabetics. In addition to antidiabetics, 2.5 ± 1.86 DIMs were consumed, mainly anxiolytics (25.53%), opioids (23.03%), other analgesics and antipiretics (19.13%), and antidepressants (17.73%). Collaboration between pharmacists and physicians is a priority to clearly transmitting risks to patients. It is necessary that the health authorities include information on DIMs, such as the DRUID classification, in the prescription and dispensing software.
Highlights
Diabetes Mellitus (DM) is one of the most prevalent chronic disease worldwide [1], affecting more than 400 million people [2]
From 2015 to 2018, five millions of packages of antidiabetics were dispensed to the population (Supplementary Table S2), mostly oral antidiabetics (71.47%) than insulins (28.53%)
These findings show that the real proportion of consumers into the general population was 3.98%, 3.13% under an oral antidiabetic, 1.56% under insulin, and 0.71% under both an oral antidiabetic and an insulin
Summary
Diabetes Mellitus (DM) is one of the most prevalent chronic disease worldwide [1], affecting more than 400 million people [2]. Diabetes can affect fitness to drive [1,4,5,6]. Chronic complications, such as retinopathy or peripheral neuropathy, can impair sensory or motor function [6,7]. Acute complications, such as hypoglycemia or hyperglycemia, can affect perception, motor skills, cognition, and judgment, and may cause loss of consciousness during driving [7,8], which may result in road crashes [9,10,11]. Notwithstanding, the results from studies on driving impairment in patients with DM may be contradictory, even in the face of the existing evidence on hypoglycemia [15], leading to the current restrictions for these patients to drive, as established in Europe and the USA [4,8,16]
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