Driving with Type 1 Diabetes: Real-World Evidence to Support Starting Glucose Level and Frequency of Monitoring During Journeys

Steven Trawley, Amanda N Stephens, Sybil A McAuley, Jane Speight, Christel Hendrieckx, Sara Vogrin, Melissa H Lee, Barbora Paldus, Leon A Bach, Morton G Burt, Neale D Cohen, Peter G Colman, Elizabeth A Davis, D Jane Holmes-Walker, Alicia J Jenkins, Joey Kaye, Anthony C Keech, Kavita Kumareswaran, Richard J MacIsaac, Roland W McCallumCatriona M Sims, Stephen N Stranks, Vijaya Sundararajan, Glenn M Ward, Timothy W Jones, David N O'Neal

Research output: Contribution to journalArticlepeer-review

Abstract

There is limited evidence supporting the recommendation that drivers with insulin-treated diabetes need to start journeys with glucose >90 mg/dL. Glucose levels of drivers with type 1 diabetes were monitored for 3 weeks using masked continuous glucose monitoring (CGM). Eighteen drivers (median [IQR] age 40 [35, 51] years; 11 men) undertook 475 trips (duration 15 [13, 21] min). Hypoglycemia did not occur in any trip starting with glucose >90 mg/dL (92%; n = 436). Thirteen drivers recorded at least one trip (total n = 39) starting with glucose <90 mg/dL. Among these, driving glucose was <70 mg/dL in five drivers (38%) during 10 trips (26%). Among five drivers (28%), a ≥ 36 mg/dL drop was observed within 20 min of starting their journey. Journey duration was positively associated with maximum glucose change. These findings support current guidelines to start driving with glucose >90 mg/dL, and to be aware that glucose levels may change significantly within 20 min. A CGM-based, in-vehicle display could provide glucose information and alerts that are compatible with safe driving. Clinical Trial Registration number: ACTRN12617000520336.

Original languageEnglish
Pages (from-to)350-356
Number of pages7
JournalDiabetes Technology & Therapeutics
Volume24
Issue number5
Early online date15 Mar 2022
DOIs
Publication statusPublished - May 2022

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