Diabetes and Driving Mishaps

Diabetes and Driving Mishaps Frequency and correlations from a multinational survey Daniel J. Cox , PHD 1 , Jennifer Kim Penberthy , PHD 1 , John Zrebiec , MSW 2 , Katie Weinger , PHD 2 , James E. Aikens , PHD 3 , Brian Frier , MD 4 , Barbara Stetson , PHD 5 , Mary DeGroot , PHD 6 , Paula Trief , PHD 7 , Hartmut Schaechinger , MD 8 , Norbert Hermanns , PHD 9 , Linda Gonder-Frederick , PHD 1 and William Clarke , MD 1 1 University of Virginia Health System, Charlottesville, Virginia 2 Joslin Diabetes Center, One Joslin Place, Boston, Massachusetts 3 University of Chicago, Chicago, Illinois 4 Royal Infirmary, Edinburgh, Scotland 5 University of Louisville, Louisville, Kentucky 6 Washington University, St. Louis, Missouri 7 SUNY Upstate Medical University, Syracuse, New York 8 University Hospital, Basel, Switzerland 9 Research Institute of the Diabetes Academy, Mergentheim, Germany. Address correspondence and reprint requests to Daniel J. Cox, PhD, Box 800223, University of Virginia Health Systems, Charlottesville, VA 22908. E-mail: djc4f{at}virginia.edu Abstract OBJECTIVE —The intensive treatment of diabetes to achieve strict glycemic control is a common clinical goal, but it is associated with an increased incidence of hypoglycemia. Becoming hypoglycemic while driving is a hazardous condition and may lead to a greater incidence of driving mishaps. This study investigated whether diabetes is associated with increased risk of driving mishaps and correlates of such a relationship. RESEARCH DESIGN AND METHODS —During routine visits to diabetes specialty clinics in seven U.S. and four European cities, consecutive adults with type 1 diabetes, type 2 diabetes, and nondiabetic spouse control subjects ( n = 341, 332, and 363, respectively) completed an anonymous questionnaire concerning diabetes and driving. RESULTS —Type 1 diabetic drivers reported significantly more crashes, moving violations, episodes of hypoglycemic stupor, required assistance, and mild hypoglycemia while driving as compared with type 2 diabetic drivers or spouse control subjects ( P < 0.01–0.001). Type 2 diabetic drivers had driving mishap rates similar to nondiabetic spouses, and the use of insulin or oral agents for treatment had no effect on the occurrence of driving mishaps. Crashes among type 1 diabetic drivers were associated with more frequent episodes of hypoglycemic stupor while driving, less frequent blood glucose monitoring before driving, and the use of insulin injection therapy as c