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Maxwell H, Dubois S, Cottrell-Martin E, Regalado SM, Stinchcombe A, Migay M, Gibbons C, Weaver B, Bédard M. The association between diabetes and safe driving: A systematic search and review of the literature and cross-reference with the current guidelines. Diabet Med 2023; 40:e15175. [PMID: 37422905 DOI: 10.1111/dme.15175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/21/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Abstract
AIMS We conducted this review to characterize the quality of evidence about associations between diabetes and safe driving and to evaluate how these findings are reflected within current guidelines available to support clinicians and their patients with diabetes. METHODS The first stage entailed a systematic search and review of the literature. Evidence surrounding harms associated with diabetes and driving was identified, screened, extracted and appraised for quality utilizing the Newcastle Ottawa Scales (NOS). Next, relevant guidelines regarding driving and diabetes were sourced and summarized. Finally, the identified guidelines were cross-referenced with the results of the systematic search and review. RESULTS The systematic search yielded 12,461 unique citations; 52 met the criteria for appraisal. Fourteen studies were rated as 'high', two as 'medium' and 36 as 'low'. Studies with ratings of 'high' or 'medium' were extracted, revealing a body of inconsistent methods and findings. These results, cross-referenced with the guidelines, suggest a lack of agreement and a limited evidence base to justify recommendations. CONCLUSIONS The results presented emphasize the need for a better understanding of the impacts of diabetes on safe driving to inform evidence-based guidelines.
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Affiliation(s)
- Hillary Maxwell
- Centre for Applied Health Research, St. Joseph's Care Group, Thunder Bay, Ontario, Canada
- Centre for Research on Safe Driving, Lakehead University, Thunder Bay, Ontario, Canada
- Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada
| | - Sacha Dubois
- Centre for Applied Health Research, St. Joseph's Care Group, Thunder Bay, Ontario, Canada
- Centre for Research on Safe Driving, Lakehead University, Thunder Bay, Ontario, Canada
- School of Nursing, Lakehead University, Thunder Bay, Ontario, Canada
- NOSM University, Thunder Bay, Ontario, Canada
| | - Elyse Cottrell-Martin
- Centre for Applied Health Research, St. Joseph's Care Group, Thunder Bay, Ontario, Canada
| | - Sophie M Regalado
- Centre for Applied Health Research, St. Joseph's Care Group, Thunder Bay, Ontario, Canada
- Centre for Research on Safe Driving, Lakehead University, Thunder Bay, Ontario, Canada
- NOSM University, Thunder Bay, Ontario, Canada
| | - Arne Stinchcombe
- Centre for Research on Safe Driving, Lakehead University, Thunder Bay, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Marcia Migay
- Centre for Applied Health Research, St. Joseph's Care Group, Thunder Bay, Ontario, Canada
| | - Carrie Gibbons
- Centre for Applied Health Research, St. Joseph's Care Group, Thunder Bay, Ontario, Canada
| | - Bruce Weaver
- Centre for Research on Safe Driving, Lakehead University, Thunder Bay, Ontario, Canada
| | - Michel Bédard
- Centre for Applied Health Research, St. Joseph's Care Group, Thunder Bay, Ontario, Canada
- Centre for Research on Safe Driving, Lakehead University, Thunder Bay, Ontario, Canada
- Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada
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Gutiérrez-Abejón E, Criado-Espegel P, Pedrosa-Naudín MA, Fernández-Lázaro D, Herrera-Gómez F, Álvarez FJ. Trends in the Use of Driving-Impairing Medicines According to the DRUID Category: A Population-Based Registry Study with Reference to Driving in a Region of Spain between 2015 and 2019. Pharmaceuticals (Basel) 2023; 16:ph16040508. [PMID: 37111265 PMCID: PMC10145018 DOI: 10.3390/ph16040508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023] Open
Abstract
The European DRUID (Drive Under the Influence of drugs, alcohol, and medicines) program classifies medications into three categories according to their effect on one’s fitness to drive. The trend in the use of driving-impairing medicines (DIMs) in a region of Spain between 2015 and 2019 was analyzed through a population-based registry study. Pharmacy dispensing records for DIMs are provided. The use of DIMs on drivers was weighted according to the national driver’s license census. The analysis was performed considering the population distribution by age and sex, treatment length, and the three DRUID categories. DIMs were used by 36.46% of the population and 27.91% of drivers, mainly chronically, with considerable daily use (8.04% and 5.34%, respectively). Use was more common in females than in males (42.28% vs. 30.44%) and increased with age. Among drivers, consumption decreases after 60 years of age for females and after 75 years of age for males. There was a 34% increase in the use of DIMs between 2015 and 2019, with a focus on daily use (>60%). The general population took 2.27 ± 1.76 DIMs, fundamentally category II (moderate influence on fitness to drive) (20.3%) and category III (severe influence on fitness to drive) (19.08%). The use of DIMs by the general population and drivers is significant and has increased in recent years. The integration of the DRUID classification into electronic prescription tools would assist physicians and pharmacists in providing adequate information to the patient about the effects of prescribed medications on their fitness to drive.
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Chang YH, Hou WH, Wu KF, Li CY, Hsu IL. Risk of motorcycle collisions among patients with type 2 diabetes: a population-based cohort study with age and sex stratifications in Taiwan. Acta Diabetol 2022; 59:1625-1634. [PMID: 36103089 DOI: 10.1007/s00592-022-01967-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/29/2022] [Indexed: 11/01/2022]
Abstract
AIMS To investigate the overall and sex-age-specific absolute and relative risks of motorcycle collisions at road traffic accidents among patients with type 2 diabetes. METHODS A cohort study in Taiwan was conducted by following 989,495 patients with type 2 diabetes and the same number of matched controls recruited between 2010 and 2012 to the end of 2016. Collision events by motorcycle driver victims were identified from the Police-reported Traffic Accident Registry. Overall and sex-age-specific incidence rates of collision involving motorcycle driver victims were estimated under Poisson assumption. The Cox proportional hazard regression models were performed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of collision in association with type 2 diabetes. RESULTS Over an up to 7 years of follow-up, patients with type 2 diabetes had a higher incidence rate of motorcycle collision than controls at 1.16 and 0.89 per 100 person-years, respectively, which represented a significantly elevated HR of 1.28 (95% CI 1.27-1.30) after adjusting for potential confounders including various diabetic complications. The elevated HR was similarly seen in both men and women patients, and was significantly decreasing with increasing age regardless of sex. Little evidence supported the dose-response relationship between duration of type 2 diabetes and motorcycle collision risk. CONCLUSIONS After adjustment for common diabetic complications and comorbidities that could impair driving performance, patients with type 2 diabetes still suffered from increased risk of motorcycle collisions, regardless of sex, but was more evident in younger than in older patients.
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Affiliation(s)
- Ya-Hui Chang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Hsuan Hou
- College of Medicine, National Cheng Kung University, Tainan, Taiwan
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ke-Fei Wu
- Department of Accounting Information, Chihlee University of Technology, New Taipei, Taiwan
- Department of Business Management, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - I-Lin Hsu
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Hou WH, Chang YH, Hendrati LY, Isfandiari MA, Li CY, Hsu IL. Evaluation of motor vehicle crashes between scooter riders and car drivers after diagnosis of type 2 diabetes in Taiwan. Injury 2022; 53:3950-3955. [PMID: 36224056 DOI: 10.1016/j.injury.2022.09.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/18/2022] [Accepted: 09/25/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Despite the plausibility that diabetes may increase the risk of motor vehicle crashes (MVCs) due to various diabetes related complications and co-morbidity, findings from epidemiological studies on the relationship between diabetes and MVCs remained inclusive mainly due to heterogeneity in the study design and failure to complete consideration of potential confounders. This study re-visited this putative association with an improved study design. METHOD This study employed a controlled before-after study design and included 1,264,280 people aged 18-75 years with T2D newly diagnosed from 2009-2014 and an equal number of age-, sex-, and time-matched controls. The rate ratios (RRs) of vehicle type-specific incidence rates of MVCs in the 1 and 2 years before and after diabetes diagnosis (or the matched dates) were compared between the individuals with type 2 diabetes (T2D) and their matched controls. RESULTS The rate of MVCs increased slightly among people with T2D over 1 and 2 years following diabetes diagnosis, with RRs of 1.04 (95% confidence interval [CI]=1.02-1.07) and 1.11 (95% CI=1.09-1.13), respectively. These RRs were comparable to those obtained for controls (1.06 and 1.12, respectively). By contrast, the RRs of scooter crashes were significantly higher in the T2D group than in the control group during the 1 year (1.28 vs. 1.08, p < 0.001) and 2 years (1.32 vs. 1.08, p < 0.001) following diabetes diagnosis. CONCLUSION T2D diagnosis was associated with a moderate but significant increase in the risk of MVCs among scooter drivers, but not among car drivers.
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Affiliation(s)
- Wen-Hsuan Hou
- College of Medicine, National Cheng Kung University, Tainan, Taiwan; School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan; Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ya-Hui Chang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Lucia Yovita Hendrati
- Department of Epidemiology, Biostatistics, Population Studies and Health Promotion, Faculty of Public Health, University of Airlangga, Surabaya, Indonesia
| | - Muhammad Atoillah Isfandiari
- Department of Epidemiology, Biostatistics, Population Studies and Health Promotion, Faculty of Public Health, University of Airlangga, Surabaya, Indonesia
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Epidemiology, Biostatistics, Population Studies and Health Promotion, Faculty of Public Health, University of Airlangga, Surabaya, Indonesia; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - I-Lin Hsu
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Ridel D, Borowsky A, Shalev Shamay R, Hershkovitz E, Parmet Y, Haim A. Does gender affect the driving performance of young patients with diabetes? ACCIDENT; ANALYSIS AND PREVENTION 2022; 167:106569. [PMID: 35074566 DOI: 10.1016/j.aap.2022.106569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 11/30/2021] [Accepted: 01/11/2022] [Indexed: 06/14/2023]
Abstract
Recent evidence suggests that poor glycemic control among young patients with type 1 diabetes mellitus (T1DM) has negative cognitive and physical effects, whose extent is gender-dependent. For example, female patients with diabetes present more physical and cognitive limitations than male patients in terms of cognitive adjustment, quality of decision making, and functioning. Studies about traffic safety report that diabetic drivers are at increased risk of being involved in road crashes, especially when driving in a state of hypoglycemia under which their blood glucose level is too low. We have recently demonstrated that acute hyperglycemia (when the blood glucose level is too high) can also lead to poor driving performance among T1DM young adult patients. Against this background, the objective of the present study was to find out whether gender affects the driving performance of young drivers with diabetes. Twenty-six T1DM drivers participated in a counterbalanced crossover experiment. While being monitored by an eye tracker, they drove a driving simulator and twice navigated through the nine hazardous scenarios: once under a normal blood glucose (euglycemia) level and once high blood glucose (hyperglycemia) level. The first main result is that young female drivers are more affected by diabetes than young male drivers, regardless of momentary glycemic changes. The second main result is that poor glycemic control substantially deteriorates hazard perception and driving performance of young males with diabetes. Thus, it is argued that an uncontrolled state of a high blood glucose level may be more hazardous for young males with diabetes since it negatively impacts their driving performance.
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Affiliation(s)
- Dana Ridel
- Dept. of Industrial Engineering & Management, Ben-Gurion University of the Negev (BGU), Israel.
| | - Avinoam Borowsky
- Dept. of Industrial Engineering & Management, Ben-Gurion University of the Negev (BGU), Israel
| | - Rotem Shalev Shamay
- Pediatric Endocrinology Unit, Soroka Medical Center, Faculty of Health Sciences, BGU, Israel
| | - Eli Hershkovitz
- Pediatric Endocrinology Unit, Soroka Medical Center, Faculty of Health Sciences, BGU, Israel
| | - Yisrael Parmet
- Dept. of Industrial Engineering & Management, Ben-Gurion University of the Negev (BGU), Israel
| | - Alon Haim
- Pediatric Endocrinology Unit, Soroka Medical Center, Faculty of Health Sciences, BGU, Israel
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Leon SJ, Trachtenberg A, Briscoe D, Ahmed M, Hougen I, Askin N, Whitlock R, Ferguson T, Tangri N, Rigatto C, Komenda P. Opioids and the Risk of Motor Vehicle Collision: A Systematic Review. J Pharm Technol 2022; 38:54-62. [PMID: 35141728 PMCID: PMC8820048 DOI: 10.1177/87551225211059926] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023] Open
Abstract
Background: Opioid analgesics are among the most commonly prescribed medications, but questions remain regarding their impact on the day-to-day functioning of patients including driving. We set out to perform a systematic review on the risk of motor vehicle collision (MVC) associated with prescription opioid exposure. Method: We searched Medline, PubMed, EMBASE, Scopus, and TRID from January 1990 to August 31, 2021 for primary studies assessing prescribed opioid use and MVCs. Results: We identified 14 observational studies that met inclusion criteria. Among those, 8 studies found an increased risk of MVC among those participants who had a concomitant opioid prescription at the time of the MVC and 3 found no significant increase of culpability of fatal MVC. The 3 studies that evaluated the presence of a dose-response relationship between the dose of opioids taken and the effects on MVC risk reported the existence of a dose-response relationship. Due to the heterogeneity of the different studies, a quantitative meta-analysis to sum evidence was deemed unfeasible. Our review supports increasing evidence on the association between motor vehicle collisions and prescribed opioids. This research would guide policies regarding driving legislation worldwide. Conclusion: Our review indicates that opioid prescriptions are likely associated with an increased risk of MVCs. Further studies are warranted to strengthen this finding, and investigate additional factors such as individual opioid medications, opioid doses and dose adjustments, and opioid tolerance for their effect on MVC risk.
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Affiliation(s)
- Silvia J. Leon
- Department of Community Health
Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB,
Canada
- Chronic Disease Innovation Centre,
Seven Oaks General Hospital, Winnipeg, MB, Canada
| | - Aaron Trachtenberg
- Department of Community Health
Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB,
Canada
| | - Derek Briscoe
- Max Rady College of Medicine,
University of Manitoba, Winnipeg, MB, Canada
| | | | - Ingrid Hougen
- Department of Community Health
Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB,
Canada
- Max Rady College of Medicine,
University of Manitoba, Winnipeg, MB, Canada
| | - Nicole Askin
- Neil John Mclean Library, University of
Manitoba, Winnipeg, MB, Canada
| | - Reid Whitlock
- Department of Community Health
Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB,
Canada
- Chronic Disease Innovation Centre,
Seven Oaks General Hospital, Winnipeg, MB, Canada
| | - Thomas Ferguson
- Department of Community Health
Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB,
Canada
- Chronic Disease Innovation Centre,
Seven Oaks General Hospital, Winnipeg, MB, Canada
| | - Navdeep Tangri
- Department of Community Health
Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB,
Canada
- Chronic Disease Innovation Centre,
Seven Oaks General Hospital, Winnipeg, MB, Canada
| | - Claudio Rigatto
- Department of Community Health
Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB,
Canada
- Chronic Disease Innovation Centre,
Seven Oaks General Hospital, Winnipeg, MB, Canada
| | - Paul Komenda
- Department of Community Health
Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB,
Canada
- Chronic Disease Innovation Centre,
Seven Oaks General Hospital, Winnipeg, MB, Canada
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Roze S, Isitt JJ, Smith-Palmer J, Lynch P. Evaluation of the Long-Term Cost-Effectiveness of the Dexcom G6 Continuous Glucose Monitor versus Self-Monitoring of Blood Glucose in People with Type 1 Diabetes in Canada. CLINICOECONOMICS AND OUTCOMES RESEARCH 2021; 13:717-725. [PMID: 34408456 PMCID: PMC8366033 DOI: 10.2147/ceor.s304395] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/28/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Dexcom G6 real-time continuous glucose monitoring (RT-CGM) system is one of the most sophisticated RT-CGM systems developed to date and became available in Canada in 2019. A health economic analysis was performed to determine the long-term cost-effectiveness of the Dexcom G6 RT-CGM system versus SMBG in adults with type 1 diabetes (T1D) in Canada. METHODS The analysis was performed using the IQVIA Core Diabetes Model. Based on clinical trial data, patients with mean baseline HbA1c of 8.6% were assumed to have a HbA1c reduction of 1.0% with RT-CGM versus 0.4% reduction with SMBG. RT-CGM was also associated with a quality of life (QoL) benefit owing to reduced incidence of hypoglycemia, reduced fear of hypoglycemia (FoH) and elimination of fingerstick testing. Direct medical costs were sourced from published literature, and inflated to 2019 Canadian dollars (CAD). RESULTS Dexcom G6 RT-CGM was projected to improve mean quality-adjusted life expectancy by 2.09 quality-adjusted life years (QALYs) relative to SMBG (15.52 versus 13.43 QALYs) but mean total lifetime cots were CAD 35,353 higher with RT-CGM (CAD 227,357 versus CAD 192,004) resulting in an incremental cost-effectiveness ratio (ICER) of CAD 16,931 per QALY gained. Sensitivity analyses revealed that assumptions relating to the QoL benefit associated with reduced FoH and the elimination of fingerstick testing with RT-CGM as well as SMBG usage and change in HbA1c were the key drivers of cost-effectiveness. CONCLUSION For adults with T1D in Canada, RT-CGM is associated with improved glycemic control and QoL benefits owing to a reduced FoH and elimination of the requirement for fingerstick testing and over a lifetime time horizon is cost-effective relative to SMBG.
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Haim A, Shalev Shamy R, Ridel D, Parmet Y, Loewenthal N, Liberty I, Tejman-Yarden S, Hershkovitz E, Borowsky A. Acute hyperglycaemia can impair driving skill in young type 1 diabetes mellitus patients. DIABETES & METABOLISM 2020; 47:101176. [PMID: 32735952 DOI: 10.1016/j.diabet.2020.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/22/2020] [Accepted: 07/08/2020] [Indexed: 11/30/2022]
Abstract
AIM Drivers with diabetes are at increased risk of being involved in road accidents. Therefore, this study aimed to evaluate the effects of acute hyperglycaemia (AH) compared with euglycaemia on driving ability in patients with type 1 diabetes mellitus (T1DM). METHODS Eighteen drivers with T1DM were asked to navigate twice through nine hazardous scenarios, using a driving simulator, during euglycaemia and then again during AH (mean blood glucose: 138 ± 34 mg/dL and 321 ± 29 mg/dL, respectively) in a counterbalanced crossover study. Driving performance was continually monitored for driving speed, steering wheel angle, acceleration, and location and velocity of other vehicles and obstacles, with drivers wearing a mobile head-mounted eye-tracking system. RESULTS The main findings were that, during AH, participants were less likely to identify a hazard [probability of identification (POI): 0.5725 ± 0.5], glanced fewer times at the hazard (3.24 ± 5.9), maintained shorter headway (between-vehicle) distance (mean: 40.87 ± 20.15 m) and had an increased number of braking events per km driven (6.69 ± 5.20) compared with driving during euglycaemia (POI: 0.733 ± 0.4; number of glances: 3.69 ± 6.99; headway distance: 50.46 ± 26.2 m; number of braking events per km driven: 4.31 ± 3.87; P < 0.05 for all parameters). CONCLUSION This study provides evidence that AH impairs driving performance in young T1DM patients by demonstrating the negative effects of AH on both hazard perception and speed management.
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Affiliation(s)
- Alon Haim
- Pediatric Endocrinology & Diabetes Unit, Soroka University Medical Center, Beer Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
| | - Rotem Shalev Shamy
- Pediatric Endocrinology & Diabetes Unit, Soroka University Medical Center, Beer Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Dana Ridel
- Department of Industrial Engineering & Management, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Yisrael Parmet
- Department of Industrial Engineering & Management, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Neta Loewenthal
- Pediatric Endocrinology & Diabetes Unit, Soroka University Medical Center, Beer Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Idit Liberty
- Department of Internal Medicine, Adult Diabetes Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Shai Tejman-Yarden
- Edmond J. Safra International Congenital Heart Center, Sheba Medical Center, Ramat Gan, Israel
| | - Eli Hershkovitz
- Pediatric Endocrinology & Diabetes Unit, Soroka University Medical Center, Beer Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Avinoam Borowsky
- Department of Industrial Engineering & Management, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Population-Based Registry Analysis of Antidiabetics Dispensations: Trend Use in Spain between 2015 and 2018 with Reference to Driving. Pharmaceuticals (Basel) 2020; 13:ph13080165. [PMID: 32722515 PMCID: PMC7464462 DOI: 10.3390/ph13080165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 12/20/2022] Open
Abstract
Insulins and some oral antidiabetics are considered to be driving-impairing medicines (DIM) and they belong to the Driving under the Influence of Drugs, alcohol, and medicines (DRUID) category I (minor influence on fitness to drive). The trend of antidiabetics use in Castilla y León from 2015 to 2018 is presented through a population-based registry study. Treatment duration with these medicines and the concomitant use of other DIMs were observed. An adjustment method was used with information from the drivers' license census. For all calculations, age and gender were taken into account. 3.98% of the general population used at least one antidiabetic, as well as 2.92% of drivers. The consumption of antidiabetics in men was higher than in women (4.35% vs. 3.61%, p = 0.001), and the use increases with age, especially from 35-39 years to 75-79 years in men and 85-89 years in women. Antidiabetics were consumed chronically, specifically 100% in the case of insulins and 95% in the case of oral antidiabetics. In addition to antidiabetics, 2.5 ± 1.86 DIMs were consumed, mainly anxiolytics (25.53%), opioids (23.03%), other analgesics and antipiretics (19.13%), and antidepressants (17.73%). Collaboration between pharmacists and physicians is a priority to clearly transmitting risks to patients. It is necessary that the health authorities include information on DIMs, such as the DRUID classification, in the prescription and dispensing software.
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Chung IM, Rajakumar G, Subramanian U, Venkidasamy B, Khanna VG, Thiruvengadam M. Insights on the current status and advancement of diabetes mellitus type 2 and to avert complications: An overview. Biotechnol Appl Biochem 2020; 67:920-928. [PMID: 31736194 DOI: 10.1002/bab.1853] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/12/2019] [Indexed: 01/11/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is an endocrine metabolic disorder, occurring worldwide due to aging, advancement in lifestyle by modernization. T2DM is characterized by higher levels of glucose in the blood due to unresponsive secretion of pancreatic insulin and insulin activity or altogether. T2DM is regarded as a powerful genetic susceptible disease that leads to high risk with insulin resistance and β-cell dysfunction. To manage and overcome type 2 diabetes, physical activity, diet strategies, and other therapeutic medications along with usage of antiglycemic agents are developed and attempted appropriately. In the present review, attention has been focused on the understanding of T2DM outcomes, complications with possible management strategies, and pathophysiology of T2DM. Further, a detailed note on antiglycemic agents in use and other possible drugs of choice was discussed in the light of current preventive strategies are presented in this review.
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Affiliation(s)
- Ill-Min Chung
- Department of Crop Science, College of Sanghuh Life Science, Konkuk University, Seoul, Republic of Korea
| | - Govindasamy Rajakumar
- Department of Crop Science, College of Sanghuh Life Science, Konkuk University, Seoul, Republic of Korea
| | - Umadevi Subramanian
- Translational Research Platform for Veterinary Biologicals, Central University Laboratory Building, Tamil Nadu Veterinary and Animal Sciences University (TANUVAS), Madhavaram Milk Colony, Chennai, Tamil Nadu, India
| | - Baskar Venkidasamy
- Department of Biotechnology, Bharathiar University, Coimbatore, Tamil Nadu, India
| | - Venkatesan Gopiesh Khanna
- Department of Biotechnology, Vels Institute of Science, Technology & Advanced Studies (VISTAS), Pallavaram, Chennai, Tamil Nadu, India
| | - Muthu Thiruvengadam
- Department of Crop Science, College of Sanghuh Life Science, Konkuk University, Seoul, Republic of Korea
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Insulin-Treated Diabetes and Driving: Legal Jeopardy and Consequences of Hypoglycemia. Can J Diabetes 2019; 43:221-223. [DOI: 10.1016/j.jcjd.2018.08.201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/16/2018] [Accepted: 08/30/2018] [Indexed: 11/17/2022]
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Mancini GBJ, Cheng AY, Connelly K, Fitchett D, Goldenberg R, Goodman S, Leiter LA, Lonn E, Paty B, Poirier P, Stone J, Thompson D, Verma S, Woo V, Yale JF. CardioDiabetes: Core Competencies for Cardiovascular Clinicians in a Rapidly Evolving Era of Type 2 Diabetes Management. Can J Cardiol 2018; 34:1350-1361. [DOI: 10.1016/j.cjca.2018.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/13/2018] [Accepted: 07/13/2018] [Indexed: 12/18/2022] Open
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