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Type 1 Diabetes Driving Mishaps Common

Type 1 Patients Have Twice as Many Accidents, Violations as Type 2 Patients and Non-Diabetics
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WebMD Health News

Aug. 20, 2003 -- Driving accidents and traffic violations are twice as common among people with type 1 diabetes as in people with type 2 diabetes or those without the disease, suggests a new study that explains why: One in three people with type 1 diabetes surveyed say they had experienced at least one hypoglycemic stupor in a two-year period.

Hypoglycemia results when blood sugar levels are abnormally low -- causing trembling, dizziness, confusion, belligerence, blurred vision, and sometimes unconsciousness. They can occur frequently in people with diabetes on insulin therapy, those attempting to achieve "tight" (near) normal glucose control with intensive insulin therapy, and in people with diabetes that have numerous complications from the disease. By comparison, episodes of hypoglycemia were reported by only 8% of people with type 2 diabetes.

Though hypoglycemia is generally more likely to occur in any person with diabetes who requires insulin, researchers found no difference in traffic mishaps between people with type 2 diabetes who use insulin and those who did not. In fact, patients with type 2 diabetes had a similar rate of accidents as people without diabetes -- and half their rate of traffic violations.

But the study's lead researcher says the real message of these findings, published in this month's issue of Diabetes Care, is that many doctors fail to warn patients who have diabetes about the potential dangers of driving with low blood sugar levels.

"Most of the patients in our study say their doctors never spoke to them about hypoglycemia driving, even though they are legally liable to do so," Daniel J. Cox, PhD, of the University of Virginia, tells WebMD. "There's one case where a patient had a hypoglycemic stupor, drove off the road, and had a head-on collision that killed a mother and her daughter in other car. That patient and the family of the victim then sued the physician because he knew the patient was having hypoglycemia but never counseled him that he shouldn't be driving under such conditions."

Cox, director of the university's Behavioral Medicine Center and a professor of psychiatric medicine who has done previous research on this topic, and his colleagues distributed anonymous questionnaires to 341 type 1 diabetic people, 322 type 2 diabetic people, and 363 non-diabetic spouses in the U.S. and Europe.

Sixteen percent of those with type 1 diabetes and 8% of those with type 2 diabetes surveyed in the U.S. reported car crashes in the two-year study period. Among European participants, the gap was closer -- accidents occurred among 23% of type 1 and 19% of type 2 patients.

Check Blood Sugar Before Driving

"My recommendation is that diabetics should never start driving when their blood glucose is below 90 mg/dL -- not because they are impaired at that level, but it wouldn't take them to drop much further to be impaired," he tells WebMD. "If it's below 70 mg/dL, they need to take some fast-acting carbohydrates before driving and not resume driving until their blood glucose recovers, which can take up to 30 minutes."

Is This Normal? Get the Facts Fast!

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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