Motor Vehicle Accidents in Patients with Diabetes and Tight Glycemic Control

Motor Vehicle Accidents in Patients with Diabetes and Tight Glycemic Control: Uncontrolled diabetes can impair the ability to drive, and lead to serious complications. Careful diabetic control is a standard of good practice, but in this study, patients with the tightest control of glucose levels as measured with HbA1c levels had an increased risk for motor vehicle accidents. The study authors emphasized the difficulty in assessing the driving fitness of patients with diabetes, and that HbA1c levels may be an inappropriate measure. The investigators identified 795 patients with diabetes and documented HbA1c levels. Of this group 57 were involved in motor vehicle crashes. The mean HbA1c of crash victims with diabetes was 7.4% vs 7.9% for non-crash patients with diabetes (P = .019). The investigators calculated that lowering the HBA1c level by 1% increased the risk for a vehicular accident by 25% (95% confidence interval = 2%-55%). Other risk factors for sustaining a crash were severe hypoglycemia and increased age at onset of diabetes. In this selected population, tighter glycemic control, as measured by the HbA1c, is associated with an increased risk of a motor vehicle crash. PLoS Med. 2009; 6(12):e1000192 (ISSN: 1549-1676)