This study sought to determine the effect of acute hyperglycaemia on driving skills in 18 individuals with type 1 diabetes. In a crossover design separated by at least 1 week between sessions, participants performed a computer-based simulated driving test in either euglycaemia (mean blood glucose, 7.7 mmol/L) or acute hyperglycaemia (17.8 mmol/L), in a randomized order.
The mean age of the participants was 24.5 years and they had been driving without supervision for a mean of 5.7 years. Only seven were vehicle owners, and seven had previously been in accidents. In the acute hyperglycaemic state, participants reported significantly more severe autonomic symptoms, including trembling, difficulty concentrating and visual disturbances.
During hyperglycaemia, participants were less likely to identify a hazard (probability of identification, 0.57 vs 0.73), looked at the hazard less (3.24 vs 3.69 glances), drove closer to other vehicles (between-vehicle distance, 40.9 vs 50.5 metres) and had more braking events per kilometre driven (6.7 vs 4.3 events) compared with euglycaemia (P<0.05 for all comparisons).
The authors conclude that driving in acute hyperglycaemia impairs both hazard perception and speed management in young drivers with type 1 diabetes. They suggest that hyperglycaemia should not be ignored when driving, and that people with diabetes should consistently monitor their blood glucose to maintain proper levels whist driving.
Haim A, Shalev Shamy R, Ridel D et al (2020) Acute hyperglycaemia can impair driving skill in young type 1 diabetes mellitus patients. Diabetes Metab 28 Jul [epub ahead of print] https://doi.org/10.1016/j.diabet.2020.07.003
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