Many Diabetic Patients With Recurrent Severe Hypoglycemias Hold a Valid Driving License. A Community-Based Study in Insulin-Treated Patients With Diabetes

Abstract

Objective: We studied retrospectively the current driving license status in insulin-treated diabetic patients, who had severe hypoglycemia (SH) within an observation period of one year and who lived in two Finnish communities.

Methods: The episodes of SH were identified from local ambulance registers, the databases of local health care units and from patient questionnaires in 680 insulin-treated diabetic patients. The data on current driving licenses were obtained from local police authorities.

Results: Of type 1 and type 2 insulin-treated diabetic patients 31.0 and 12.3 percent, respectively, had at least one self-reported SH, whereas 53 (7.8%) of them reported even three or more episodes of SH. Of insulin-treated patients with clustering of SH 68 percent still held a driving license, and 21percent of them held even a license for commercial vehicles up to 3.5 tons.

Conclusions: Recurrent episodes of SH occur in a minority of insulin-treated diabetic patients. However, two thirds of them still held a valid driving license even for commercial vehicles, which violates the medical standards for diabetes and driving.

Keywords:

• Driving license
• Hypoglycemia
• Insulin
• Diabetes

ACKNOWLEDGMENTS

This study benefited from the support of the Kyllikki and Uolevi Lehikoinen Foundation, the Finnish Primary Health Care Research Foundation (Avohoidon tutkimussäätiö), and the Finnish Diabetes Research Foundation. We thank the nurses of the Kouvola and Nurmijärvi Health Centres who participated in gathering the data. Moreover, we thank the network of Academic Health Centres (AcaHC), a doctoral education unit at Helsinki University, for valuable discussion.