Do You Agree That Tight Blood Sugar Control Can Lead to Increased Risk of Car Crashes?

Type 1 and LADA
#1

A new study says that people with diabetes that maintain tigher blood sugar control are at a greater risk of having a car crash. I want to know if you agree or disagree with with this study’s findings

The study suggests that people with tightly controlled diabetes are more likely to have hypoglycemic events leading to loss of consciousness or dizzyness, which can contribute to or cause a crash. We ran an about the study on Diabetes news Hound. Check it out here: Car Crash Risk Greater for Diabetics with Tight Blood Sugar Control

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#2

I am in disagreement Chris! I have always maintained tight control of my BG’s - and NEVER been in an accident (even on a snow blizzard day like we’re having today). My BG’s tend to be in the 70-108 mg/dl (4-6 mmol/l) range. Now, is that considered “tight control” to you?

Yikes, I hope Canadian insurance companies don’t start to ask what our A1C levels are - mine is below what the article says - so I maybe considered a risk on the road! I go thru’ enough hassles maintaining my drivers license here in Quebec - every 2 years - fork out $$$'s to get medical forms filled out by endo / ortho - so far - no question of what my current A1C level has even been asked - but insurance companies may demand it with the increase in diabetes. Hmm, maybe I should get my huskies hitched onto the sled tomorrow !

I know on the cruise I just got off, that one woman I met (only pumper I met during my week of R&R) I think was abit surprised by my A1C levels were (6% at present) - as well as what I try to keep my BG readings at. At 80 mg/dl (4.4 mmol/l) - she was would be taking 15g of carbs as she feels she’s too low. Again, I’m used to being in these BG ranges, if you’re not, then an 80 will fill low I guess. Again, every one is different, just had a friend of mine who is MDI tell me her latest A1C was 4.6% - but I think she has alot of hypos (she’s told me she can’t drive for more then 2 hours - then she gets low - but she pulls over to take care of it).

#3

I think it’s self-evident that trying to keep tight control is more likely to lead to more lows. If you drive and have more lows, an accident is also more likely. Not that you’re not doomed to having an accident, it’s just more likely.

This leads me to imagine this scenario:

Health Insurer: Looks like you’ve got pretty tight control. Guess you don’t need these supplies anymore, so we’e not paying for them.
Auto Insurer: Looks like you’ve got pretty tight control. We’re raising your rates.

Terry

#4

This makes me very angry! It is because of studies like this, and the irresponsible actions of some diabetics (you know who you are), that many extremely conscientious diabetics are considered “unsafe” and will probably find our insurance rates rising over the years.

I test before driving each and every time. I keep fast acting glucose with me at all times. If I feel slightly “funny” I pull over and test again.

There is absolutely no excuse for diabetics not to follow these simple steps. If you don’t want to do so, you shouldn’t be driving while diabetic.

#5

you know, if hypo’s are contributing to the crashes, I would suggest that the control wasn’t all that tight!

#6

I don’t think that the issue is going to be insurance rates going up, if anything it’ll be the DMV asking for your A1C and deciding if you get a license at all. There are plenty of health conditions that can lead to increased incidence of car accidents (eg, seizure disorders, vision impairments, etc) but these are regulated at the state level by the DMV. Auto insurance companies never ask those questions. I don’t think the DMV or insurance companies are checking medical records on any one, it wouldn’t be cost effective. I don’t know the stats, but I’d be willing to bet that the number of accidents caused by any medical conditions is extremely low, let alone hypoglycemia specifically. Not worth the time to gather that info for the 1 or 2 tightly controlled diabetics you’d catch.

As I understand the law in Illinois, health care providers are encouraged (if not required) to notify the DMV if a driver has a condition that may impair their driving. Also, I know for a fact on the IL license application they ask if you have any health conditions that impair driving.

#7

ah, i guess it is the definition of control then… avoiding both is control to me

#8

This might be another case of the lead-in to the story or the headline overstating the case. What the study found was that in a group of diabetics, those that had been driving when an accident occurred had a lower A1C on average than those that hadn’t been in an accident. 7.4 v. 7.9. Not a wide difference and I’d hardly call 7.4 ‘tight control.’

The author’s think that they ‘might’ be able to attribute 1/3 of the accidents to low blood sugar. Big ‘might’ if you ask me.

From the original story:

“The main problem with the study was that the records were not a random sample of people with diabetes. People with diabetes make their own choices about whether or how to drive. So, for example, people with the highest HbA1c levels might be more worried about their diabetes and choose not to drive at all, therefore reducing their risk of having a car accident to zero. Or people with low levels might feel their diabetes was well under control, and might be happy to drive faster. These sorts of things could skew the figures, making well-controlled diabetes look more dangerous than it actually is.” (emphasis mine)

Ya think?

Still, it doesn’t change my opinion that ‘tight control’ increases the risk of a hypo and therefore the risk of a hypo induced accident. Take Shannon’s advice.

Be careful out there.

Terry

#9

What an absurd statement.

Studies have found that people who swim are more likely to drown:)

Let’s keep circulating shoddy research so more people can see it on the web & believe it’s true.

#10

Hey now! It was on the internet, it’s gotta be true!!

/wink

#11

Must be! I did a search it came up numerous sites, including on TuD:)

My sister-in-law’s cousin’s friend’s neighbor knows someone who knows the guy who did the study–wink back.

#12

I think your sister-in-law’s cousin’s friend’s neighbor must be my best friend’s husband’s aunt’s ex-boyfriend :wink:

#13

Its not the same thing as, “people who swim are more likely to drown.” That would be the same as saying, “People who drive are more likely to be in car accidents.”

The mean A1C was lower for those in a crash than those who were not. Therefore, the lower HbA1c levels were associated with an increased risk of a motor vehicle crash. Doesn’t matter is this is 0.2 or 8.0 there is a statistical association. The most significant point from the study is that the risk of a crash quadrupled when a driver had a history of severe hypoglycemia that required outside help.

And before everyone gets any more upset with the researchers (which is completely absurd), the lead author of the study stated, “The basic implication of our study is to underscore the difficulty in judging fitness-to-drive in adults with severe diabetes mellitus. This pitfall calls into question traffic laws that prevail in the United States, United Kingdom, Canada, Germany, Holland, Australia, and other countries.”

So, the authors of the study are saying that its difficult to determine fitness based on BG control! They’re agreeing with us! So, everyone take a deep breathe, and relax.

And here’s a link to the actual study if you’d like to confirm what I’ve stated here: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000192

#14

This research is neither shoddy, nor absurd, and in fact is a benefit to diabetics. Please see my reply below…

#15

Thank you Tim.

#16

Would have to agree w/ Scott that “tight control” would mean avoiding both highs and lows. Anna K is a great example.
Ciao
Phil

#17

Might need a clearer definition of “tight.” BTW…I’m T-1 with a consistent sub-7 A1c & have crashed my car while hypo.

#18

This about sums it up!!

#19

Wait wait wait.

The study finds that there is a statistical relation between lower HbA1C and accidents yet also concludes that “the data suggest that a patient’s HbA1c level is neither necessary nor sufficient for determining fitness-to-drive.”

So, the lead-in to the story and/or it’s headline is misleading. There is a statistical correlation but the two facts, lower HbA1c and car crashes have nothing to do with one another. Am I reading this right?

Terry

#20

Ahh shucks Phil - thanks for the high 5! I do try my best to maintain a pretty even BG, tho’ after tonights dessert - may spike up, but I’ve got the combo bolus down pat with my pump most of the time, so I remain pretty consistent with not going up too much or down. That’s the reason I went to a pump, to have better control of BG’s, as I was having hypos too much, but my A1C’s were in the 7% range.

Off to shovel more snow, darn stuff keeps on shaking out of the sky for some reason. I’m getting anxious to get my skis on and hit the slopes (tho’ I x-country - don’t do downhill - I’m too afraid of high speeds - and this coming from a motorcyclist ).