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e | e | Diabetics often decide to drive when blood-sugar dangerously lowAugust
24, 1999 CHICAGO (AP) -- Diabetics often decide to drive even when their blood-sugar levels are so low that they could lose coordination and even black out, a study suggests. "That is not to mean that they should necessarily have their drivers' privileges taken away or restricted," said Dr. William L. Clarke of the University of Virginia Health Sciences Center at Charlottesville. Instead, Clarke said, diabetics should be aware of the danger of relying on their ability to detect low blood sugar without measuring it. Almost 45 percent of the time, the diabetics in the study said they would drive when they believed their blood sugar to be below 70 milligrams per tenth of a liter of blood. Previous research among diabetics using driving simulators has shown that blood-sugar levels below 65 lead to loss of control -- swerving, spinning and wandering off the road. The participants all had type 1 diabetes, which affects about 1 million Americans. All type 1 diabetics must take insulin, often several times a day, to help them metabolize sugar into energy. The findings were published in Wednesday's Journal of the American Medical Association. Previous studies have yielded conflicting data about whether type 1 diabetics have a higher risk of traffic accidents because of fluctuations in blood sugar, Clarke said. He and his colleagues did not analyze accident rates among the participants. Clarke said diabetics might not realize their blood sugar has fallen because how and when people experience symptoms varies. Symptoms may include shakiness, trembling, sweating, pounding heart, irritability, inability to think clearly, visual disturbance and lack of coordination. The condition is treated by eating or taking glucose tablets, which type 1 diabetics always should carry. The researchers studied 65 adult diabetics, who entered data into hand-held computers several times a day for several weeks. They recorded how they felt, what they estimated their blood sugar to be and whether they would drive. Then, each diabetic measured his or her blood sugar. A second group of 93 diabetics was enrolled two years later and similarly studied. Amazingly, Clarke said, 38 percent of the first group and 18 percent of the second said they would drive when they believed their blood sugar to be below 40, slightly above the level at which people begin to black out. Dr. Bruce R. Zimmerman, president of the American Diabetes Association, said diabetics should be trained to be more aware of the danger in driving with low blood sugar. Some diabetics have virtually no symptoms but can be taught to pick up subtle signals, he said.
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