A new approach to identifying the effect of diabetic peripheral neuropathy on the ability to drive safely

•Diabetic peripheral neuropathy affects multiple aspects of driving performance.•Drivers withneuropathy use the mid-range of the accelerator pedalmuch less.•Use of the steering wheel, and eye-steering coordination are alsoboth affected.•Drivers with neuropathy occasionally experience difficulty controllingthe vehicle.•Drivingwith neuropathy improves when driving the same route a second time. The purpose of this study was to estimate the potential for impaired driving performance in current drivers with diabetic peripheral neuropathy compared to healthy controls. We analysed, using a driving simulator, three important aspects of driving - use of the accelerator pedal, steering wheel and eye-steering coordination - to test for any differences, and then to integrate these findings to identify a unique pattern of changes in people driving with diabetic peripheral neuropathy. Patients with diabetic peripheral neuropathy displayed differences in use of the accelerator pedal compared to healthy control drivers (p