ALEXANDRIA, VA, Dec 20, 2011 (MARKETWIRE via COMTEX) —
Determining whether someone’s diabetes poses a driving risk should
be done on an individual basis and tied to concrete evidence of risk,
rather than on a diagnosis of diabetes alone, according to a new
position statement by the American Diabetes Association, being
published in a special supplement to the January issue of Diabetes
Care. The special supplement also includes the annual update of the
Association’s Standards of Medical Care in Diabetes.
The Standards of Medical Care in Diabetes, first published in 1989
and updated annually, are created to provide the best possible
guidance to health care professionals for diagnosing and treating
adults and children with all forms of diabetes. The Standards are
based upon the most current scientific evidence, which is rigorously
reviewed by the Association’s multi-disciplinary Professional
Practice Committee. The Committee addresses diabetes in a variety of
settings, including schools, home, hospitals (for both inpatients and
outpatients), prisons, workplaces and now our nation’s roadways.
This year, the Standards of Care include a section that specifically
addresses driving and diabetes, which warns against “blanket
restrictions” on driving for people with diabetes, and urges
“individual assessment by a health care professional knowledgeable in
diabetes” when considering restrictions for licensure. The Standards
of Care refer to a separate document being issued simultaneously, the
Association’s Position Statement on driving and diabetes, which notes
that “[s]ometimes persons with a strong interest in road safety —
including motor vehicle administrators, pedestrians, drivers and
other road users, and employers — associate all diabetes with unsafe
driving when, in fact, most people with diabetes safely operate motor
vehicles without creating any meaningful risk of injury to themselves
or others… The challenges are to identify high-risk individuals and
develop measures to assist them to lower their risk for driving
mishaps.”
Accordingly, the Association calls for evaluating certain patients
for “decreased awareness of hypoglycemia, hypoglycemia episodes while
driving, or severe hypoglycemia. Patients with retinopathy or
peripheral neuropathy require assessment to determine if those
complications interfere with operation of a motor vehicle. Health
care professionals should be cognizant of the potential risk of
driving with diabetes and counsel their patients about detecting and
avoiding hypoglycemia while driving.”
The Position Statement also calls for institution of a standardized
questionnaire that would help identify those individuals with
diabetes who may require further evaluation for driving risks, rather
than the current inconsistent system of state laws that range from no
restrictions at all for people with diabetes to stringent
restrictions on all people with diabetes.
“This country needs a far more consistent, fair and equitable means
of determining driving risk when it comes to people with diabetes,”
said Daniel Lorber, MD, FACP, CDE, a member of the Professional
Practice Committee and Chair of the writing group that developed the
position statement on diabetes and driving. “The vast majority of
people with diabetes have no problems driving safely whatsoever, and
should not be held to restrictions that may interfere with their
ability to work or live an otherwise normal life,” said Lorber,
Director of Endocrinology at New York Hospital of Queens in Flushing,
NY. “It is important to remember that all people with diabetes do not
have the same symptoms, or take the same measures to manage their
disease. However, it is also important that we identify those who may
pose a risk behind the wheel, and help to better educate people with
diabetes about how to reduce those risks.”
The Position Statement cites research comparing the risk for someone
with diabetes of having a motor vehicle accident to that of the
general population (12-19 percent increased risk overall), but as a
means of perspective, also includes elevated risk levels for other
populations not currently restricted from driving. “For example,
16-year old males experience 42 times more collisions than 35 to
45-year old females,” it points out. “Drivers with attention
deficit/hyperactivity disorder have a relative-risk ratio of
approximately 4, while those with sleep apnea have a relative risk of
about 2.4. If society tolerates these conditions, it would be
unjustified to restrict the driving privileges of a whole class of
individuals who are at much lower risk, such as drivers with
diabetes.”
The 2012 Standards of Medical Care also include the addition of a
section and a table on common co-morbidities, or other medical
conditions more common in people with diabetes, such as sleep apnea,
fatty liver disease, bone fracture risk and hearing impairment.
Diabetes Care, published by the American Diabetes Association, is the
leading peer-reviewed journal of clinical research into one of the
nation’s leading causes of death by disease. Diabetes also is a
leading cause of heart disease and stroke, as well as the leading
cause of adult blindness, kidney failure, and non-traumatic
amputations.
The American Diabetes Association is leading the fight to stop
diabetes and its deadly consequences and fighting for those affected
by diabetes. The Association funds research to prevent, cure and
manage diabetes; delivers services to hundreds of communities;
provides objective and credible information; and gives voice to those
denied their rights because of diabetes. Founded in 1940, our mission
is to prevent and cure diabetes and to improve the lives of all
people affected by diabetes. For more information please call the
American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or
visit
www.diabetes.org . Information from both these sources is
available in English and Spanish.
Contact:
Colleen Fogarty
American Diabetes Association
(703) 549-1500 ext. 2146
SOURCE: American Diabetes Association
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