Skurtveit S, Strøm H, Skrivarhaug T, Mørland J, Bramness J G, Engeland A
Norwegian Institute of Public Health, Oslo, Norway.
Diabet Med. 2009 Apr;26(4):404-8. doi: 10.1111/j.1464-5491.2009.02699.x.
To investigate, at a national level, whether patients using insulin or oral glucose-lowering agents had an increased risk of road traffic accidents compared with non-users.
All Norwegians aged 18-69 years (3.1 million) were followed from April 2004 until September 2006. Information on drug prescriptions, road traffic accidents and emigration/death was obtained from the following population-based registries: the Prescription Database, the Road Accident Registry and the Central Population Registry. The exposure period was the time from the first prescription of insulin or oral glucose-lowering agent during the study period. The incidence of accidents in the exposed person-time was compared with the incidence of accidents in the unexposed person-time by standardized incidence ratio (SIR).
During the study period, 20 494 road traffic accidents with personal injuries were registered in Norway. One hundred and eighty-three accidents were registered for insulin users not taking oral glucose-lowering agents and 219 for users of oral blood glucose-lowering drugs without insulin. The SIR (95% confidence interval) for all ages and both genders combined were: insulin 1.4 (1.2-1.6), oral glucose-lowering agents 1.2 (1.0-1.3) and users of drugs for peptic ulcer and gastro-oesophageal reflux disease (negative comparators) 1.3 (1.2-1.4). The highest SIRs were found among the youngest insulin users (18-34 years old).
A slightly increased risk of being involved in a road traffic accident was observed for drivers prescribed insulin, while no increased risk was observed for drivers prescribed oral glucose-lowering agents. The increased risk observed for insulin users was similar to that observed for users of drugs for peptic ulcer and gastro-oesophageal reflux disease.
在全国范围内调查使用胰岛素或口服降糖药的患者与未使用者相比，道路交通事故风险是否增加。
对2004年4月至2006年9月期间所有18至69岁的挪威人（310万）进行随访。从以下基于人群的登记处获取药物处方、道路交通事故以及移民/死亡信息：处方数据库、道路事故登记处和中央人口登记处。暴露期为研究期间首次开具胰岛素或口服降糖药处方的时间。通过标准化发病率比（SIR）比较暴露人群时间内的事故发生率与未暴露人群时间内的事故发生率。
在研究期间，挪威登记了20494起有人身伤害的道路交通事故。未服用口服降糖药的胰岛素使用者登记了183起事故，未使用胰岛素的口服降糖药使用者登记了219起事故。所有年龄和性别的综合SIR（95%置信区间）为：胰岛素1.4（1.2 - 1.6），口服降糖药1.2（1.0 - 1.3），消化性溃疡和胃食管反流病药物使用者（阴性对照）1.3（1.2 - 1.4）。最高的SIR出现在最年轻的胰岛素使用者（18 - 34岁）中。
观察到开具胰岛素处方的驾驶员道路交通事故风险略有增加，而开具口服降糖药处方的驾驶员未观察到风险增加。胰岛素使用者观察到的风险增加与消化性溃疡和胃食管反流病药物使用者观察到的风险增加相似。
