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Some Diabetics Drive When Blood Sugar Is Dangerously Low

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Margaret Himelfarb, a board member of the Juvenile Diabetes Foundation International and the mother of a son with diabetes, adds two more reasons: the fact that people with low blood sugar have some impairment in their thinking ability or that they may have misunderstood the question asked in the study.

"The one thing that I don't see [in the study] is whether or not they might have expected that they would have a snack and then get behind the wheel," she says. "It is so obvious to them, such a part of their lives. ... It is conceivable they may have misunderstood the directive."

Clarke concedes that misunderstanding may be a possibility, but he considers it unlikely that so many of the people studied would have made the same mistake. "I don't think the numbers would bear that out," he says. "All of us physicians wish that our patients would make good decisions, ... and it is our responsibility to review with them the many things that could be dangerous in their lives and help them to be safer."

"Although the statistics from a variety of sources ... can't ... show that there are more accidents among people with type 1 diabetes, there is most likely a tremendous amount of underreporting of automobile accidents by people with type 1 diabetes," says Clarke. "I mean, you just wouldn't announce 'Oh, I have diabetes,' if you wrecked a car."

"It is important to note, as [the researchers] have, that there has never been any evidence that people with type 1 diabetes have higher accident rates, because I think that is the first conclusion that people are likely to draw," says Himelfarb.

The researchers stress the importance of counseling type 1 diabetics on the risks associated with low blood sugar and driving, and they suggest that diabetics test their blood sugar level before driving.

"One other thing the article mentions is the importance of carrying some form of glucose with you; that way, you always have something in the car so that ... you can immediately treat yourself," says Himelfarb. "It doesn't hurt to throw in another [test] before you get in the car -- obviously that is a great inconvenience, but it is important to do and make sure your blood sugar is where you want it to be. People who manage their diabetes well can do everything anyone else can with no greater risk. The key thing is testing blood glucose and keeping it within normal limits. It's important not only for driving but to prevent all the complications that go with diabetes."

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