TY - JOUR
T1 - Driving with Type 1 Diabetes
T2 - Real-World Evidence to Support Starting Glucose Level and Frequency of Monitoring During Journeys
AU - Trawley, Steven
AU - Stephens, Amanda N.
AU - McAuley, Sybil A.
AU - Speight, Jane
AU - Hendrieckx, Christel
AU - Vogrin, Sara
AU - Lee, Melissa H.
AU - Paldus, Barbora
AU - Bach, Leon A.
AU - Burt, Morton G.
AU - Cohen, Neale D.
AU - Colman, Peter G.
AU - Davis, Elizabeth A.
AU - Holmes-Walker, D. Jane
AU - Jenkins, Alicia J.
AU - Kaye, Joey
AU - Keech, Anthony C.
AU - Kumareswaran, Kavita
AU - MacIsaac, Richard J.
AU - McCallum, Roland W.
AU - Sims, Catriona M.
AU - Stranks, Stephen N.
AU - Sundararajan, Vijaya
AU - Ward, Glenn M.
AU - Jones, Timothy W.
AU - O'Neal, David N.
AU - Australian JDRF Closed-Loop Research Group
PY - 2022/5
Y1 - 2022/5
N2 - 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.
AB - 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.
KW - Blood glucose self-monitoring
KW - Blood glucose/analysis
KW - Driving
KW - Humans
KW - Road safety
KW - Time in range
KW - Type 1 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85130002787&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1099379
U2 - 10.1089/dia.2021.0460
DO - 10.1089/dia.2021.0460
M3 - Article
C2 - 35156852
AN - SCOPUS:85130002787
SN - 1520-9156
VL - 24
SP - 350
EP - 356
JO - Diabetes Technology and Therapeutics
JF - Diabetes Technology and Therapeutics
IS - 5
ER -