Intensive diabetes treatment to achieve strict control of blood sugar is a common clinical goal, Dr. Daniel J. Cox, of the University of Virginia Health Systems, Charlottesville, and colleagues note. However, it is also associated with an increased occurrence of low blood sugar, known as hypoglycemia. "Becoming hypoglycemic while driving is a hazardous condition and may lead to a greater incidence of driving mishaps," they write.

To investigate, the researchers distributed anonymous questionnaires concerning diabetes and driving to 341 type 1 diabetics, 332 type 2 diabetics and 363 nondiabetic spouses.

Compared with type 2 diabetics and spouses, type 1 diabetics experienced significantly more crashes, moving violations, episodes of hypoglycemic stupor, need for assistance, and mild hypoglycemia while driving.

Patients with type 2 diabetes and nondiabetic spouses had similar rates of driving mishaps.

Three variables contributed significantly to a higher probability of crashes among type 1 diabetic drivers, Cox and colleagues report. These included "experiencing more episodes of hypoglycemic stupor while driving, performing blood glucose monitoring less frequently before driving, and taking insulin by subcutaneous injection rather than using an insulin pump."

Half of the type 1 diabetics and three quarters of the type 2 patients had never talked with their physicians about hypoglycemia and driving. The researchers therefore urge physicians to raise the subject with appropriate patients.

Source: Yahoo News: Reuters Health: Diabetes Care, August 2003.