Road traffic accidents and diabetes: insulin use does not determine risk

Lonnen, Kathryn; Powell, Roy; Taylor, Diana; Shore, Angela C.; MacLeod, Kenneth M.

doi:10.1111/j.1464-5491.2008.02409.x

Cited by 50 publications

(40 citation statements)

References 19 publications

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“…63-89 The included studies spanned from 1992-2013. Of these studies, eight (29.6%) were conducted in Norway, 69,70,72,73,75,77,79,82 six (22.2%) in the United States, 63,64,81,83-85 five (18.5%) from Canada, 65,66,86-88 three (11.1%) from England, 71,74,76 three (11.1%) from France, 67,78,80 one (3.7%) from the Netherlands, 68 and one (3.7%) from Taiwan. 89 Eleven (40.7%) of these studies were cohort designs, while the rest consisted of case-control or variations of a case-control design.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies investigated three antihyperglycemic medications which included Insulin, 66,71,75,84,85,88 Metformin, 88 and Sulfonylurea 88 (Figure 6). Of the six studies that reported outcome measures for Insulin, only two reported a statistically significant increase in MVC.…”

Section: Resultsmentioning

confidence: 99%

“…66,75 The other four studies reported no statistically significant associations. 71,84,85,88 This may be attributed to the adjustment of covariates. One study which included the odds of having any crash or a not-at-fault crash was adjusted for age, sex, race, and annual mileage, 84 while another study was adjusted for age, gender, and days driven per week.…”

Section: Resultsmentioning

confidence: 99%

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Medication use and the risk of motor vehicle collisions among licensed drivers: A systematic review

Rudisill

Zhu

Kelley

et al. 2016

Accident Analysis & Prevention

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Objectives Driving under the influence of prescription and over-the-counter medication is a growing public health concern. A systematic review of the literature was performed to investigate which specific medications were associated with increased risk of motor vehicle collision (MVC). Methods The a priori inclusion criteria were: 1) studies published from English-language sources on or after January 1, 1960, 2) licensed drivers 15 years of age and older, 3) peer-reviewed publications, master's theses, doctoral dissertations, and conference papers, 4) studies limited to randomized control trials, cohort studies, case-control studies, or case-control type studies 5) outcome measure reported for at least one specific medication, 6) outcome measure reported as the odds or risk of a motor vehicle collision. Fourteen databases were examined along with hand-searching. Independent, dual selection of studies and data abstraction was performed. Results Fifty-three medications were investigated by 27 studies included in the review. Fifteen (28.3%) were associated with an increased risk of MVC. These included Buprenorphine, Codeine, Dihydrocodeine, Methadone, Tramadol, Levocitirizine, Diazepam, Flunitrazepam, Flurazepam, Lorazepam, Temazepam, Triazolam, Carisoprodol, Zolpidem, and Zopiclone. Conclusions Several medications were associated with an increased risk of MVC and decreased driving ability. The associations between specific medication use and the increased risk of MVC and/or affected driving ability are complex. Future research opportunities are plentiful and worthy of such investigation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Medication use and the risk of motor vehicle collisions among licensed drivers: A systematic review

Rudisill

Zhu

Kelley

et al. 2016

Accident Analysis & Prevention

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“…Some published studies indicated that drivers with type 1 diabetes have a slightly higher risk, with a relative risk ratio of ;2 (7,8,9), but this was not confirmed by other studies (10). Two studies even suggested that there is no increased risk associated with insulintreated diabetes (11,12), but the methodologies used have been criticized (13).…”

Section: Understanding the Risk Of Diabetes And Drivingmentioning

confidence: 99%

Diabetes and Driving

2013

Diabetes Care

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“…It has been reported in the past in the UK to justify a plea of not guilty based on hypoglycemia unawareness [7]. Because of their propensity to develop hypoglycemia, diabetic patients are more likely to be involved in an accident during driving only slightly more than the rest of the population [8,9]. …”

Section: Neuroglycopaenia Automatismmentioning

confidence: 99%

Neuroglycopaenia Automatism and Driving Culpability

Khan¹

2018

FRCIJ

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Hypoglycemia unawareness is a stage of automatism in a neuroglycopaenic state of the brain for insulin treated diabetes mellitus patients. Most of the Medicolegal and legal fraternity need awareness in examining such patients when they have an accident while driving. There should be a clear guidelines for people suffering from diabetes and are on insulin and oral hypoglycemic. Diabetic patients, because of their propensity to develop hypoglycemia, are more likely to be involved in a driving accident, although only slightly more than the rest of the population. Therefore, it has been a matter of debate since the earliest days of insulin therapy whether patients on insulin therapy should be allowed to have a driving license or not. Heavy vehicle licensing should be properly evaluated on regular intervals for the safety of patients, others people on the road, and the vehicle.

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Road traffic accidents and diabetes: insulin use does not determine risk

Abstract: Our findings suggest that insulin-treated patients as a group do not pose an increased risk to road safety. They reiterate the need for an individualized risk-based assessment when considering driving restrictions.

Cited by 50 publications

References 19 publications

Medication use and the risk of motor vehicle collisions among licensed drivers: A systematic review

Medication use and the risk of motor vehicle collisions among licensed drivers: A systematic review

Diabetes and Driving

Neuroglycopaenia Automatism and Driving Culpability

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