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Drugs, driving and traffic safety in diabetes mellitus

  • Igor A. Harsch
  • Katharina Hoesl

Abstract

Several diabetes-related conditions can impair the driving ability of diabetic patients. These include visual loss due to retinopathy, sensory-motor impairment due to neuropathy, cardiovascular disease, and amputation. Caused sometimes by rapid onset, hypoglycaemic events belong to the most dangerous situations in traffic not only for the diabetic patient, but for other traffic participants as well. The main reason for hypoglycaemias is insulin therapy, but some oral antidiabetic drugs (sulfonylureas, glinides) in widespread use also have hypoglycaemia-inducing properties. To date, insulin therapy and its consequences on traffic safety have been at the focus of research.

Unfortunately, the available studies provide no consistent picture of the traffic safety of insulin-treated patients. Frequent methodological problems include retrospective analysis, not distinguishing between insulin-dependent and insulin-independent patients, no distinction between the different modes of insulin therapy, no clear emphasis and description of comorbidities and other medications of the patients. Furthermore, many of these studies rely on official data that only quantify accidents or traffic violations or are predicated on self reports. Although there is no doubt that hypoglycaemias during driving occur, the studies show a tendency - but no clear evidence — that patients with diabetes are significantly more involved in road traffic accidents than the population in general. The ambiguous picture presented by the different studies has led to variable strategies by the licensing authorities concerning diabetic patients throughout the world. Since the outcome of a traffic hypoglycaemia also depends on the patient’s ability to detect and to counteract this situation, the increase in patient education of recent decades may have played a positive role. Apart from the participation of subjects with hypoglycaemia unawareness in hypoglycaemia awareness trainings, further recommendations include measuring blood glucose levels before and also during longer drives, especially for those individuals who have lost the symptoms of low blood glucose and have a history of driving mishaps.

Keywords

Traffic Safety Motor Vehicle Crash Active Learning Exercise ORQJ Whup WUHDWHG ZLWK 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Birkhäuser Verlag/Switzerland 2009

Authors and Affiliations

  • Igor A. Harsch
    • 1
  • Katharina Hoesl
    • 2
  1. 1.Department of Medicine 1, Division of Endocrinology and MetabolismUniversity of Erlangen-NurembergErlangenGermany
  2. 2.Department of NeurologyUniversity of Erlangen-NurembergErlangenGermany

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