Motor vehicle crashes in diabetic patients with tight glycemic control: a population-based case control analysis.
| Autor: | Donald A Redelmeier, Anne B Kenshole, Joel G Ray |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: | |
| Zdroj: | PLoS Medicine, Vol 6, Iss 12, p e1000192 (2009) |
| Druh dokumentu: | article |
| ISSN: | 1549-1277 1549-1676 |
| DOI: | 10.1371/journal.pmed.1000192 |
| Popis: | BACKGROUND: Complications from diabetes mellitus can compromise a driver's ability to safely operate a motor vehicle, yet little is known about whether euglycemia predicts normal driving risks among adults with diabetes. We studied the association between glycosylated hemoglobin (HbA1c) and the risk of a motor vehicle crash using a population-based case control analysis. METHODS AND FINDINGS: We identified consecutive drivers reported to vehicle licensing authorities between January 1, 2005 to January 1, 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 lower for those in a crash than controls (7.4% versus 7.9%, unpaired t-test, p = 0.019), equal to a 26% increase in the relative risk of a crash for each 1% reduction in HbA1c (odds ratio = 1.26, 95% confidence interval 1.03-1.54). The trend was evident across the range of HbA1c values and persisted after adjustment for measured confounders (odds ratio = 1.25, 95% confidence interval 1.02-1.55). The two other significant risk factors for a crash were a history of severe hypoglycemia requiring outside assistance (odds ratio = 4.07, 95% confidence interval 2.35-7.04) and later age at diabetes diagnosis (odds ratio per decade = 1.29, 95% confidence interval 1.07-1.57). CONCLUSIONS: In this selected population, tighter glycemic control, as measured by the HbA1c, is associated with an increased risk of a motor vehicle crash. |
| Databáze: | Directory of Open Access Journals |
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