Progressive hypoglycemia's impact on driving simulation performance. Occurrence, awareness and correction

Progressive hypoglycemia's impact on driving simulation performance. Occurrence, awareness and correction. D J Cox , L A Gonder-Frederick , B P Kovatchev , D M Julian and W L Clarke Behavioral Medicine Center, University of Virginia Health System, Charlottesville 22908, USA. djc4f@virginia.edu Abstract OBJECTIVE: Progressive hypoglycemia leads to cognitive-motor and driving impairments. This study evaluated the blood glucose (BG) levels at which driving was impaired, impairment was detected, and corrective action was taken by subjects, along with the mechanisms underlying these three issues. RESEARCH DESIGN AND METHODS: There were 37 adults with type 1 diabetes who drove a simulator during continuous euglycemia and progressive hypoglycemia. During testing, driving performance, EEG, and corrective behaviors (drinking a soda or discontinuing driving) were continually monitored, and BG, symptom perception, and judgement concerning impairment were assessed every 5 min. Mean +/- SD euglycemia performance was used to quantify z scores for performance in three hypoglycemic ranges (4.0-3.4, 3.3-2.8, and