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Driving with Type 1 Diabetes: Real-World Evidence to Support Starting Glucose Level and Frequency of Monitoring During Journeys
journal contributionposted on 01.05.2022, 00:00 authored by S Trawley, A N Stephens, S A McAuley, Jane SpeightJane Speight, Christel HendrieckxChristel Hendrieckx, S Vogrin, M H Lee, B Paldus, L A Bach, M G Burt, N D Cohen, P G Colman, E A Davis, D J Holmes-Walker, A J Jenkins, J Kaye, A C Keech, K Kumareswaran, R J MacIsaac, R W McCallum, C M Sims, S N Stranks, V Sundararajan, G M Ward, T W Jones, D N O'Neal
There is limited evidence supporting the recommendation that drivers with insulin-treated diabetes need to start journeys with glucose >90 mg/dL. Glucose levels of drivers with type 1 diabetes were monitored for 3 weeks using masked continuous glucose monitoring (CGM). Eighteen drivers (median [IQR] age 40 [35, 51] years; 11 men) undertook 475 trips (duration 15 [13, 21] min). Hypoglycemia did not occur in any trip starting with glucose >90 mg/dL (92%; n = 436). Thirteen drivers recorded at least one trip (total n = 39) starting with glucose <90 mg/dL. Among these, driving glucose was <70 mg/dL in five drivers (38%) during 10 trips (26%). Among five drivers (28%), a ≥ 36 mg/dL drop was observed within 20 min of starting their journey. Journey duration was positively associated with maximum glucose change. These findings support current guidelines to start driving with glucose >90 mg/dL, and to be aware that glucose levels may change significantly within 20 min. A CGM-based, in-vehicle display could provide glucose information and alerts that are compatible with safe driving. Clinical Trial Registration number: ACTRN12617000520336.