Diabetes mellitus and traffic incidents

Veneman, Th.F.

doi:10.1016/0300-2977(95)00105-0

Cited by 11 publications

(7 citation statements)

References 17 publications

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“…Neuroglycopenia affects the ability to react instantly in a complex situation, like traffic. During hypoglycaemia, the risk of traffic accidents is increased [13]. Relatively mild levels of hypoglycaemia have been shown to disrupt driving behaviour [14], and although patients are aware of their impairment, they hesitate to raise their bg under these circumstances [15].…”

Section: Discussionmentioning

confidence: 99%

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Blood Glucose Awareness Training in Dutch Type 1 diabetes patients. Short‐term evaluation of individual and group training

Broers¹,

Cessie

Vliet

et al. 2002

Diabetic Medicine

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Section: Discussionmentioning

confidence: 99%

“…The percentage of decisions to drive (hhc) while the actual bg was < 3.6 mmol/l. Driving simulator experiments show significant impairments in driving performance at this level of hypoglycaemia [13].…”

Section: Methodsmentioning

confidence: 99%

Blood Glucose Awareness Training in Dutch Type 1 diabetes patients. Short‐term evaluation of individual and group training

Broers¹,

Cessie

Vliet

et al. 2002

Diabetic Medicine

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“…Hypoglycemia can affect patients' relationships, occupation, and daily activities such as driving [17,18]. However, one of the greatest impacts is patients' fear of severe hypoglycemic events, which is a limiting factor in the optimization of glycemic control [19,20].…”

Section: Importancementioning

confidence: 99%

“…These events result in transient cognitive defects, which can impact concurrent activities such as driving [18], but these fortuitously fail to show long-term cognitive consequences. Specifically, the DCCT showed that neither treatment regimen (conventional vs. multiple daily injection therapy) nor frequencies of severe hypoglycemia were associated with a cognitive decline over a mean 18 year follow up [42-44].…”

Section: Importancementioning

confidence: 99%

Insight into hypoglycemia in pediatric type 1 diabetes mellitus

Lehecka

Renukuntla

Heptulla

2012

Int J Pediatr Endocrinol

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Hypoglycemia is a common complication of insulin treatment in type 1 diabetes mellitus and can occur in any patient with diabetes when glucose consumption exceeds supply. Many studies have been done to elucidate those factors that predict severe hypoglycemia: younger age, longer duration of diabetes, lower HgbA1c, higher insulin dose, lower Body Mass Index, male gender, Caucasian race, underinsurance or low socioeconomic status, and the presence of psychiatric disorders. Hypoglycemia can affect patients' relationships, occupation, and daily activities such as driving. However, one of the greatest impacts is patients' fear of severe hypoglycemic events, which is a limiting factor in the optimization of glycemic control. Therefore, the importance of clinicians’ ability to identify those patients at greatest risk for hypoglycemic events is two-fold: 1) Patients at greatest risk may be counseled as such and offered newer therapies and monitoring technologies to prevent hypoglycemic events. 2) Patients at lower risk may be reassured and encouraged to improve their glycemic control. Since the risk of long-term complications with poor blood glucose control outweighs the risks of hypoglycemia with good blood glucose control, patients should be encouraged to aim for glucose concentrations in the physiologic range pre- and post-prandially. Advancements in care, including multiple daily injection therapy with analog insulin, continuous subcutaneous insulin infusion, and continuous glucose monitoring, have each subsequently improved glycemic control and decreased the risk of severe hypoglycemia.

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“…Other groups have suggested that with intensive education programmes, such as blood glucose awareness training (BGAT) introduced by Cox et al, patients can learn to estimate their blood glucose concentrations and speci®cally to detect hypoglycaemia at an early stage. The preliminary studies suggest that after BGAT the incidence of hypoglycaemia decreases and patients are less frequently involved in road traf®c accidents [34]. Even patients with hypoglycaemia unawareness, for whom a temporary driving ban is entirely appropriate, can regain symptomatic warning of impending hypoglycaemia and improve hypoglycaemia awareness by meticulous avoidance of hypoglycaemia [30±32].…”

Section: Clinical Issues and The Potential For Hypoglycaemia: Risk±bementioning

confidence: 99%

Diabetes and driving: towards equitable, evidence‐based decision‐making

MacLeod

1999

Diabetic Medicine

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In January 1998, the British government introduced new restrictions on licensing of people with insulin-treated diabetes mellitus to drive. These restrictions were based on the second EU driver licensing directive (91/4389) and looked to be costing insulin-treated diabetic individuals their entitlement to drive light goods and small passenger-carrying vehicles. In response to concerns expressed by the diabetes community in Britain, the British Diabetic Association commissioned a report examining and interpreting the available evidence of accident risk in insulin-treated diabetic patients, particularly that related to unexpected hypoglycaemia. The following article is drawn from that report.

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Diabetes mellitus and traffic incidents

Cited by 11 publications

References 17 publications

Blood Glucose Awareness Training in Dutch Type 1 diabetes patients. Short‐term evaluation of individual and group training

Blood Glucose Awareness Training in Dutch Type 1 diabetes patients. Short‐term evaluation of individual and group training

Insight into hypoglycemia in pediatric type 1 diabetes mellitus

Diabetes and driving: towards equitable, evidence‐based decision‐making

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