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Research Article
The metabolic demands of driving for drivers with type 1 diabetes mellitus
Article first published online: 23 OCT 2002
DOI: 10.1002/dmrr.306
Copyright © 2002 John Wiley & Sons, Ltd.
Issue
1520-7560/asset/cover.gif?v=1&s=518ef24df4af0f53197d5b36e1afedd4421360a2 "Diabetes/Metabolism Research and Reviews")
Diabetes/Metabolism Research and Reviews
Volume 18, Issue 5, pages 381–385, September/October 2002
Additional Information
How to Cite
Cox, D. J., Gonder-Frederick, L. A., Kovatchev, B. P. and Clarke, W. L. (2002), The metabolic demands of driving for drivers with type 1 diabetes mellitus. Diabetes/Metabolism Research and Reviews, 18: 381–385. doi: 10.1002/dmrr.306
Publication History
- Issue published online: 23 OCT 2002
- Article first published online: 23 OCT 2002
- Manuscript Accepted: 24 MAY 2002
- Manuscript Revised: 15 APR 2002
- Manuscript Received: 17 DEC 2001
- Abstract
- Article
- References
- Cited By
Keywords:
- diabetes;
- driving;
- hypoglycemia;
- metabolism;
- stress;
- symptoms;
- self-treatment
Abstract
Background
The active cognitive-motor demands of driving may have a significant metabolic demand that could contribute to the development of hypoglycemia. Conversely, symptoms caused by the stress of driving may be confused with hypoglycemia and lead to false alarms. This study examined the metabolic demand and the physiological stress of driving on type 1 diabetes mellitus (T1DM) drivers.
Methods
Forty-three T1DM drivers were placed on a constant insulin infusion/variable dextrose infusion to maintain euglycemia for 30 min while either watching a driving video or actually driving a simulator, in a counterbalanced crossover design. Dextrose infusion, heart rate, epinephrine, and subjective symptom ratings were measured every 5 min. Additionally, subjects were monitored for self-treatment (drinking soda).
Results
While blood glucose (BG) levels were equivalent across both conditions, actual driving was associated with a higher dextrose infusion rate (p = 0.02), more autonomic symptoms (p < 0.05), increased heart rate (p < 0.001), a trend (p = 0.09) for greater epinephrine release, and more frequent hypoglycemic self-treatment (p < 0.001).
Conclusions
Driving is a task with a significant metabolic demand, which may lower BG, and also that driving stress may be associated with symptoms similar to those of hypoglycemia. Physicians should discuss with their T1DM patients hypoglycemia and driving, and encourage measuring blood glucose before driving and during long drives. Copyright © 2002 John Wiley & Sons, Ltd.