A DGReview of :"The
metabolic demands of driving for drivers with type 1 diabetes mellitus"
Diabetes / Metabolism Research and Reviews
posted 11/19/02
By David Loshak
Physicians should encourage their patients to measure blood
glucose before driving and during long drives.
This recommendation is because driving imposes a significant metabolic demand,
which may lower blood glucose, say researchers at the University of Virginia
Health System, Charlottesville, Virginia, United States.
In addition, driving stress might be associated with symptoms similar to
hypoglycaemia.
The researchers reasoned that active cognitive-motor demands of driving might
have a significant metabolic demand which could contribute to the development of
hypoglycaemia. Conversely, they noted, the symptoms caused by the stress of
driving might be confused with hypoglycaemia and lead to false alarms.
The researchers examined the metabolic demand and physiological stress of
driving on 43 drivers with type 1 diabetes mellitus.
The drivers were put on a constant insulin infusion/variable dextrose infusion
to maintain euglycaemia for 30 minutes while either watching a driving video or
driving a simulator.
The researchers measured dextrose infusion, heart rate, epinephrine and
subjective symptom ratings every five minutes. The drivers were also monitored
for self-treatment with drinking soda.
Blood glucose levels were equivalent across both conditions but driving on the
simulator was associated with a significantly higher dextrose infusion rate.
Simulator driving was also significantly associated with more autonomic
symptoms, increased heart rate and more frequent hypoglycaemic self-treatment.
In addition, there was a trend towards greater epinephrine release.
Source: Doctor's Guide: Metabolism Research and Reviews 2002; 18(5): 381-385.
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