Increased risk of motor vehicle crashes in diabetic patients with tight glycemic control

January 01, 0001

Increased risk of motor vehicle crashes in diabetic patients with tight glycemic control

The researchers from Canda studied the association between glycosylated hemoglobin (HbA1c) and the risk of a motor vehicle crash using a population-based case control analysis. They identified consecutive drivers reported to vehicle licensing authorities between January 2005 to January 2007 who had a diagnosis of diabetes mellitus and a HbA1c documented. The risk of a crash was calculated taking into account potential confounders including blood glucose monitoring, complications, and treatments. A total of 57 patients were involved in a crash and 738 were not involved in a crash.

The mean HbA1c was significantly lower for those in a crash than controls (7.4% versus 7.9%), equal to a 26% increase in the relative risk of a crash for each 1% reduction in HbA1c (odds ratio = 1.26). The trend was evident across the range of HbA1c values and persisted after adjustment for measured confounders (odds ratio = 1.25). The two other significant risk factors for a crash were a history of severe hypoglycemia requiring outside assistance (odds ratio = 4.07) and later age at diabetes diagnosis (odds ratio per decade = 1.29).

The authors concluded: “In this selected population, tighter glycemic control, as measured by the HbA1c, is associated with an increased risk of a motor vehicle crash.”

As with other areas of medicine, whilst there is much undermanagement, there may be overmanagement.

For the full abstract, click here.

PLoS Med 6(12): e1000192. © 2009 to 2009 Redelmeier et al.
Motor Vehicle Crashes in Diabetic Patients with Tight Glycemic Control-A Population-based Case Control Analysis. Donald A. Redelmeier, Anne B. Kenshole and Joel G. Ray. Correspondence to Donald A. Redelmeier: [email protected]

Category: T. Endocrine/Metbolic/Nutritional. Keywords: crashes, motor vehicle, diabetes, glycemic control, population based case control analysis
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 13 January 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.