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Driving Isn’t An Issue for Most People With Diabetes

December 21, 2011
By

TUESDAY, Dec. 20 (HealthDay News) — Diabetes needn’t prevent
someone from driving, and only a doctor should decide if complications are
severe enough to keep an individual off the road, the American Diabetes
Association (ADA) says.

In a new position statement published in the January issue of
Diabetes Care, the association advises against blanket bans or
restrictions. Instead, it recommends that patients who have issues that
might pose a driving risk be assessed by a physician who normally cares
for people with diabetes.

“There have been inappropriate pushes to try to restrict driving
licensure for people with diabetes, and we were concerned that these
recommendations were coming from people who didn’t really know diabetes,
and were unnecessarily restrictive,” explained Dr. Daniel Lorber, chair of
the writing group that developed the position statement and director of
endocrinology at New York Hospital Queens in New York City.

“The vast majority of people with diabetes drive safely,” said Lorber.
Currently, states have different laws concerning driving and diabetes, and
the ADA would prefer to see a standard questionnaire used to assess
driving safety.

Nearly 19 million people in the United States have been diagnosed with
diabetes, a disorder involving blood sugar levels. The biggest concern
about drivers with diabetes stems from the risk of low blood sugar
(hypoglycemia), which can cause confusion and disorientation. While an
episode of hypoglycemia can affect driving ability, the ADA says such
incidences are rare.

An analysis of 15 previous studies on people with diabetes and driving
found that overall, people with diabetes have between a 12 percent and 19
percent increased risk of a motor vehicle accident compared to the general
driving population.

But, society tolerates riskier driving situations all the time. A
16-year-old boy has a 42 times higher risk of getting into a car accident
than a 35- to 45-year-old woman, according to the ADA. People with
attention-deficit hyperactivity disorder (ADHD) have about four times the
car accident risk of the general public, while those with sleep apnea are
about 2.4 times more likely to crash.

“The challenges are to identify high-risk individuals and develop
measures to assist them to lower their risk for driving mishaps,” wrote
the ADA committee.

For example, people with diabetes who take insulin are most at risk of
hypoglycemia. The ADA recommends that people who take insulin test their
blood sugar before driving and retest at regular intervals if they’re
driving for longer than one hour.

“Patients with type 1 diabetes are really normal these days. There’s no
reason to restrict their driving ability,” said Dr. Joel Zonszein,
director of the clinical diabetes center at Montefiore Medical Center in
New York City. “Patients are very smart today, and have more technology to
help them manage their diabetes and avoid hypoglycemia.”

For those at risk of serious hypoglycemia, the ADA recommends not
starting an extended drive with low normal blood sugar levels (between 70
and 90 milligrams per deciliter) without consuming some carbohydrates to
prevent against a drop in blood sugar while driving. The ADA also
recommends having a fast-acting source of carbohydrate (fruit juice, hard
candy or dextrose tablets) to quickly raise blood sugar available in the
car and keeping an extra snack, such as cheese crackers, handy, too.

Other factors related to diabetes that could affect driving include
diabetic eye disease (retinopathy) and nerve disease (peripheral
neuropathy). Retinopathy can affect vision and neuropathy can impair the
ability to feel the gas and brake pedals. If these complications are
severe, driving may become an issue.

The ADA recommends that people with diabetes who may pose a risk while
driving be evaluated by a doctor familiar with diabetes. If the condition
threatens the driver’s ability to drive safely, doctors can provide
information to state licensing agencies. The ADA doesn’t recommend
mandatory physician reporting, because it may keep people with diabetes
from discussing these issues with their doctor.

“The great majority of people with diabetes do not have an impairment
in their driving, and I applaud the ADA for their position,” said
Zonszein.

The bottom line for people with diabetes, said Lorber, is to “know what
your sugar is before you start to drive, and don’t drive if you’re below
70 mg/dL.”

More information

Read more about diabetes and driving at the U.S. National Highway Traffic Safety Administration.

Article source: http://news.yahoo.com/driving-isnt-issue-most-people-diabetes-210409736.html

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