Brief reportInconsistent blood glucose checking before driving among drivers with type 1 diabetes: Results from the Australian YourSAY: Glucose Monitoring study
Introduction
Drivers with diabetes are over-represented in road trauma statistics [1]. In Australia and the UK, people with type 1 diabetes (T1D) who drive a motor vehicle are typically required to attend a medical licensing review and submit this report to their local driver licensing authority [2], [3], [4]. In addition, guidelines suggest self-monitoring of blood glucose (SMBG) before driving and again during the journey, if driving for more than two hours [2], [5]. The rationale for these requirements is the neuroglycopenic effect of hypoglycaemia (i.e. severe cognitive disruption caused by brain glucose deprivation), which impairs driving ability [6].
Previous studies have reported on the prevalence of driving-related SMBG among people with insulin-treated diabetes. For example, among 16,000 UK drivers with insulin-treated diabetes, less than half regularly performed SMBG before, or after two hours of, driving, as recommended [7]. However, the role of driver safety attitudes to pre-driving SMBG has not been explored. Our aim was to provide the first Australian data on self-reported SMBG before and during driving among adults with T1D, and investigate the demographic, clinical and attitudinal factors that may influence the decision not to undertake SMBG before driving.
Section snippets
Methods
This study used data from the YourSAY (Self-management And You): Glucose Monitoring study, a national cross-sectional online survey of attitudes and barriers to SMBG. The survey was completed by 592 eligible participants with T1D. Of these, 50 did not hold a valid full Australian drivers licence or did not drive currently, and three did not respond to the question about pre-driving SMBG, leaving a final sample of 539 Australian drivers with T1D.
On the online survey’s homepage, a plain language
Results
Respondent characteristics are summarised in Table 1. Only one in four (24%; n = 131) ‘always’ checked their blood glucose before driving (i.e. “consistent checkers”). The majority (76% (n = 408)) indicated that they were “inconsistent checkers”: 45% (n = 240) ‘sometimes,’ 16% (n = 86) ‘rarely’, and 15% (n = 82) ‘never’. Similarly, 24% (n = 130) indicated they consistently performed SMBG after driving for more than two hours.
After covariate adjustment, five variables remained significant in the logistic
Discussion
In the current study, we found that three quarters of surveyed drivers reported inconsistent pre-driving SMBG, with a similar proportion not checking consistently if driving for two hours or more.
Those who reported no recommendation from their healthcare professional regarding pre-driving SMBG were over four times more likely to be inconsistent in this behaviour. Furthermore, those who reported less concern over safety or were less likely to carry SMBG equipment with them were twice as likely
Conflict of interest
Jane Speight is a member of the Accu-Chek Advisory Board (Roche Diagnostics Australia) and has served on an advisory board for Janssen Pharmaceuticals. Her research group has received unrestricted educational grants from Abbott Diabetes Care, Medtronic and Sanofi Diabetes; sponsorship to host or attend educational meetings from Lilly, Medtronic, MSD, Novo Nordisk, Roche Diagnostics Australia, and Sanofi Diabetes; consultancy income from Abbott Diabetes Care, Roche Diagnostics Australia and
Acknowledgments
The manuscript was composed from the data provided by Abbott Diabetes Care., but without input or alteration from Abbott Diabetes Care.
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