Drunk Diabetes: The Perils of Diabetic Driving

Above 5 To DriveJennifer Sheridan never made it to McDonalds after her daughter’s high school basketball game due to a sudden drop in blood sugar. Fortunately, her 9-year-old daughter prevented her from crashing the car by veering off the road and turning off the engine. This would not have occurred if not for Sheridan’s Type 2 diabetes [1]. In many cities, driving is essential for getting to work, meeting up with others and performing necessary daily tasks, yet driving with uncontrolled diabetes may be just as dangerous as driving while intoxicated [2].

In the United States alone, nearly 19 million people have diabetes [3]. Diabetes predominately affects women, who make up 65 percent of the diabetic population, and carries a higher risk for those with family histories of the disease[6]. This statistic potentially translates to millions of risky drivers due to diabetic side effects, such as hypoglycemia, or low blood glucose. Driving a motor vehicle is a privilege that comes with a host of responsibilities for anyone, but diabetics must take extra precautions to reduce vulnerability and maximize road safety [1].

Hypoglycemic episodes can increase the likelihood of driving mishaps.Diabetics should monitor hypoglycemia during intense exercise to identify their mental and physical condition. Nevertheless, many diabetics do not follow this protocol. One study found that 60 percent of participants had never checked their blood-glucose levels before driving [2]. University of Virginia researchers are collecting data through a public health intervention tool called Diabetes Driving [5]. This online program helps diabetics determine their risk of getting into a car accident and gives tips to reduce that risk. Researcher Daniel Cox seeks to focus on education, not restriction. “We need to understand which diabetic drivers are at high risk and why, in order to eventually develop a treatment program,” he said. Cox believes such a program can help physicians and patients understand the dangers of hypoglycemia [4]. The site aims to identify high-risk individuals and assist them in lowering their driving hazard.

In addition to problems in blood sugar levels, seizures are often another threat to be considered. A spike in blood sugar can cause faintness, loss of consciousness and decreased visual acuity. Also, low blood sugar levels can lead to a coma, or even death. Additionally, when neuropathy is severed during seizures, it limits feeling in the foot, which is required when touching a car’s pedals [3].According to a multinational survey conducted at the University of Virginia, Type 1 diabetic drivers were more likely to remain in a “hypoglycemic stupor while driving” and to have far “less blood glucose monitoring before driving” [5]. Ultimately, the researchers concluded that car accidents are more common with Type 1 diabetics, compared to Type 2 diabetics who aren’t even cognizant of their insulin intake [5].

Videographer Dan Fried could not complete the drive from his home in Long Island, New York to meet his brother at a New Jersey diner because of a diabetic episode. With drooping eyes, he appeared groggy and he slurred his words. The police pulled him over assuming he was drunk and misdiagnosed his emergency. Fried suffered “cuts, bruises and a broken wrist” from rough handling by the police, even though he sincerely asked the trooper to fetch his fruit punch [2]. Although diabetes is prevalent in roughly 26 million Americans, many advocates contest the need for more community outreach and awareness of diabetes, especially trained personnel such as police officers. Ultimately, Fried and the American Diabetes Association settled a class-action lawsuit against the city. He claims that he is a well- educated diabetic patient. Fried “has worn a medical bracelet since his childhood, keeps a jug of fruit punch and insulin in his car, and has never before had a problem with the police [7].”

Another growing issue with diabetes is the lack of communication among doctors and patients. A European study showed that half of the participants with Type 1 diabetes drivers and 75 percent of the study’s Type 2 diabetics had never talked to their physicians about driving risks associated with hypoglycemia [5]. On the other hand, we cannot just label all diabetics as inherently dangerousdrivers, as this would obviously not be true. We can reduce risky driving in diabetics through informational and preventative programs. Aforementioned University of Virginia researcher Daniel Cox has also developed a program called Blood Glucose Awareness Training, or BGAT, which teaches patients to recognize the physical implications of low blood sugar levels [1]. Management of Type I diabetes requires frequent balancing of insulin, fuel intake and medical fitness, or exercising [4]. BGAT is a psycho-educational intervention that instructs patients about glucose, insulin and how to maintain proper levels of both.

Diabetics today have countless ways to treat hypoglycemia, such as insulin therapy and the use of technology to help remind them to take their medications. Hopefully, by increasing public vigilance about diabetics, diabetes-related accidents, especially motor accidents, will diminish. Ultimately, doctors and diabetics should be more vigilant concerning the perils of diabetic driving.

References:

1. Geggel, Laura, “Precautions Urged for Drivers With Diabetes,” New York Times, Jan 28, 2013. http://well.blogs.nytimes.com/2013/01/28/precautions-urged-for-drivers-with-diabetes/.
2. Dolak, Kevin, “Girl, 9, Saves Mom From Diabetic Attack While Driving,” ABC News. ABC News Network, January 28, 2013. http://abcnews.go.com/blogs/headlines/2013/01/girl-9-saves-mom-from-diabetic-attack-while-driving/.
3. Lorber, Daniel. “Diabetes and Driving.” American Diabetes Association, 35, no.1(2012): 81-86. doi: 10.2337/dc12-s081. http://care.diabetesjournals.org/content/35/Supplement_1/S81.full
4. Cox, Daniel. “U.Va. Top News Daily.” U.Va. Top News Daily, February 8, 2013. http://www.virginia.edu/topnews/01_12_2004/diabetic_drivers.html
5. Cox, DJ. “Diabetes and Driving Mishaps: Frequency and Correlations from a Multinational Survey.” PubMed. January 28, 2013. http://www.ncbi.nlm.nih.gov/pubmed/12882857.
6. Keast, Don. “Be above 5 to Drive: Diabetes and Driving.” GWAHS Libraries Blog. N.p., 19 Sept. 2011. Web. 29 Jan. 2013.
7. Baxter, Christopher. ” Rough treatment of diabetic driver raises questions about N.J. State Police training.” The Star-Ledger. October 14th, 2012. Feb 8, 2013. http://www.nj.com/news/index.ssf/2012/10/nj_state_police_diabetes_train.html.

Image credit: GWAHS Libraries Blog

Amishi Desai is a first year student who goes to the George Washington University considering majoring in public health. Follow The Triple Helix Online on Twitter and join us on Facebook.

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