Drivers
With Type 1 Diabetes Report More Car Accidents
Study
Compares Driving Records With Type 2 Diabetics, Others
Drivers with type 1 diabetes
may be more prone to car accidents than people without diabetes or those
with type 2 diabetes, according to a report in the medical journal Diabetes
Care.
The study, by researchers at the University
of Virginia Health System, looked at whether or not diabetes treatments
to control blood sugar level are linked with increased risk for driving
mishaps.
The researchers also report that people with type 2
diabetes are not accident prone, even if they are taking insulin.
The drivers with type 1 diabetes reported significantly
more crashes, moving violations, and hypoglycemic episodes than did
patients with type 2 diabetes regardless of whether they used insulin,
according to Dr. Daniel J. Cox, a researcher on the study.
Blood
Sugars May Rise or Fall Too Quickly
According to the American Diabetes
Association, Type 1 diabetes is usually diagnosed in children
and young adults, and was previously known as juvenile diabetes.
Type 1 diabetes develops when the pancreas can no longer
manufacture insulin, the hormone necessary to move sugar out of the
blood and into tissues where it supplies energy. To compensate, those
with type 1 diabetes must rely on an outside source of insulin, usually
in the form of injections several times a day.
Type 2 diabetes is the most common form of diabetes.
In type 2 diabetes, either the body does not produce enough insulin
or the cells ignore the insulin.
Insulin is necessary for the body to be able to use
sugar. Sugar is the basic fuel for the cells in the body, and insulin
takes the sugar from the blood into the cells. When glucose builds up
in the blood instead of going into cells, it can cause two problems:
Your cells may be starved for energy, and over time, high blood glucose
levels may hurt your eyes, kidneys, nerves, or heart.
Treatment involves medications that increase insulin
sensitivity or, in some instances, supplemental insulin.
Experts say when insulin levels are not well-controlled,
there is the potential for blood sugar levels to either rise too high
or drop too low. And they strongly infer that the drop in blood sugar
more commonly seen in type 1 diabetes may precipitate the driving dangers.
"There's always the concern that patients who experience
low blood sugar - hypoglycemia - may be at greater risk when driving
or performing other tasks that require mental concentration and high
performance," says Dr. Kenneth Hupart, chief of endocrinology,
metabolism, and diabetes at Nassau University Medical Center.
"If you're driving during a period of hypoglycemia,
for example, your reaction time and judgment might be impaired,"
Dr. Hupart explains.
Although people with type 2 diabetes are also prone
to episodes of low blood sugar, Dr. Hupart says it happens far less
frequently, and usually to a lesser degree. This is one possible reason
why this group did not appear to have any greater increase in driving
risks.
The study involved 1,036 participants from seven diabetes
specialty-care centers across the US, as well as four centers in major
European cities. At each center, people with either type 1 or type 2
diabetes, as well as their non-diabetic spouses, were asked to fill
out an anonymous questionnaire concerning both their driving record
and their diabetes history for the two years prior to the survey.
According to Dr. Cox, the questions included the number
of automobile accidents and moving violations, the number of times driving
assistance was required due to low blood sugar, and how often the patient
drove while experiencing severe low blood sugar.
Also included were questions testing the patients knowledge
of low blood sugar levels, and whether they routinely tested their blood
sugar levels before getting behind the wheel.
The final analysis: When compared to drivers with type
2 diabetes, as well as non-diabetic drivers, people with type 1 diabetes
were at what the researchers called "significant risk" for
driving accidents.
Study
Points to Steps to Prepare Drivers
Dr. Hupart says the study results could be instrumental in developing
guidelines to reduce risks on the road.
He says it can offer a road map for improved patient
counseling, wherein physicians can help those patients at highest risk
of accidents alter their behaviors in such a way that this risk can
decrease.
For example, Dr. Hupart says, physicians could point
out levels of blood glucose that would be considered dangerous or unsafe
when driving, and then encourage patients who are at risk to pay attention
to their own sugar levels before getting behind the wheel.
At the same time, however, he cautions against this
or other similar studies being used to discriminate against those with
diabetes.
"We don't want to promote unjustified discrimination
against diabetics in our society, when it may not be appropriate, and
when there may be a way of identifying the risk and lowering that risk,"
Dr. Hupart says.
Always consult your physician for more information.
Online
Resources
American
Diabetes Association
Centers
for Disease Control and Prevention (CDC)
Diabetes
Care
National
Diabetes Education Program
National
Institute of Diabetes & Digestive & Kidney Diseases (NIDDKD)
National
Insitutes of Health (NIH)
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September 2003
In This
Issue:
Drivers
With Type 1 Diabetes Report More Car Accidents
Blood
Sugars May Rise or Fall Too Quickly
Study
Points to Steps to Prepare Drivers
What
Is Hypoglycemia?
Online
Resources
Other
Resources:
Find
a St. John's Mercy Physician
Diabetes
Services at St. John's Mercy
Diabetes
Health Information
St.
John's Mercy Classes and Programs
In
Other Diabetes Health News:
What
Is Hypoglycemia?
Hypoglycemia is a condition characterized by a glucose (blood sugar) level
that is too low to effectively fuel the body's blood cells.
Glucose is the main source of
fuel for the body. According to the National Institute for Diabetes and
Digestive and Kidney Diseases (NIDDK), the good range of blood sugar is
approximately 60 to 120 mg/dL (milligrams of glucose per deciliter of
blood). Blood sugar levels under 60 mg/dL are too low and are considered
unhealthy.
Hypoglycemia may be a condition
by itself, or may be a complication of diabetes or another disorder. It
is most often seen as a complication of diabetes, which is sometimes referred
to as insulin reaction.
Causes of hypoglycemia in people
with diabetes may include the following:
- too little food eaten as
compared to the amount of insulin taken
Other causes of hypoglycemia are rare, but
may occur in early pregnancy, after strenuous exercise, or during prolonged
fasting. Hypoglycemia may also result from taking certain medications,
abusing alcohol, or other rare causes.
The following are the most common
symptoms of hypoglycemia. However, each individual may experience symptoms
differently. The symptoms include:
The symptoms of hypoglycemia
may resemble other conditions or medical problems. Always consult your
physician for a diagnosis.
In addition to a complete
medical history and physician examination, certain blood tests are
used to diagnose hypoglycemia.
When a person with diabetes
has symptoms of hypoglycemia, then the cause is usually diagnosed
as a complication of diabetes, or insulin reaction. It is often the
result of the causes listed above.
Always consult your physician
for more information.
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