From the Clinical Pharmacy Department, CHU Montpellier, University Montpellier.
Clinical Research and Epidemiology Unit, CHU Montpellier, University Montpellier.
J Patient Saf. 2021 Dec 1;17(8):e1034-e1039. doi: 10.1097/PTS.0000000000000764.
This study aimed to investigate a potential daily-life concern for patients with diabetes hypoglycemia while driving by (1) estimating their incidence in insulin-treated drivers, (2) determining factors associated with their occurrence, and (3) analyzing patients' behavior regarding prevention of hypoglycemia.
We conducted an observational study from November 2013 to May 2018 in the endocrinology-diabetology-nutrition department of our university hospital. All patients treated for diabetes older than 18 years admitted in the department were eligible. A specific questionnaire assessing attitudes, knowledge, and consequences of hypoglycemia was provided. In this study, only insulin-treated patients who regularly drive were analyzed.
On the 233 insulin-treated drivers included, 45 (19%) self-reported at least 1 hypoglycemia while driving in the preceding year. Two factors were significantly associated with their occurrence: type 1 diabetes (odds ratio [OR] = 3.19; 95% confidence interval [CI] = 1.55-6.57) and experiences of asymptomatic hypoglycemia (OR = 2.20; 95% CI = 1.05-4.63). Awareness of the treatment hypoglycemia risk because of information provided by a medical specialist was also but nonsignificantly associated with hypoglycemia while driving (OR = 2.61; 95% CI = 0.86-7.92). Forty-one patients (18%) combined those 3 variables, 20 (49%) of them self-reported hypoglycemia while driving. Thirty-four percent of the patients never carried carbohydrates for hypoglycemia correction. Seventy-six percent do not monitor blood glucose level before driving.
Our questionnaire allowed us to highlight that 19% our cohort of insulin-treated drivers declared experiencing hypoglycemia while driving. Risk factors identified and prevention data collected should help us better target patient education.
本研究旨在通过（1）估计接受胰岛素治疗的驾驶员中糖尿病低血糖患者的发生率，（2）确定与低血糖发生相关的因素，以及（3）分析患者预防低血糖的行为，来研究糖尿病低血糖患者在驾驶过程中可能遇到的潜在日常问题。
我们于 2013 年 11 月至 2018 年 5 月在我们大学附属医院的内分泌学-糖尿病学-营养科进行了一项观察性研究。该部门所有接受治疗的年龄超过 18 岁的糖尿病患者均符合入选标准。我们提供了一份专门评估低血糖的态度、知识和后果的问卷。在这项研究中，仅分析了经常开车的接受胰岛素治疗的患者。
在纳入的 233 名接受胰岛素治疗的驾驶员中，有 45 名（19%）报告在过去一年中至少有一次在驾驶时发生低血糖。有两个因素与低血糖的发生显著相关：1 型糖尿病（比值比 [OR] = 3.19；95%置信区间 [CI] = 1.55-6.57）和无症状性低血糖发作（OR = 2.20；95% CI = 1.05-4.63）。因医疗专家提供的信息而意识到治疗低血糖的风险也与驾驶时低血糖发生有一定但无统计学意义的相关性（OR = 2.61；95% CI = 0.86-7.92）。41 名患者（18%）同时具备这 3 个变量，其中 20 名（49%）报告在驾驶时发生低血糖。34%的患者从未携带过碳水化合物来纠正低血糖。76%的患者在驾驶前不监测血糖水平。
我们的问卷使我们能够强调，我们的接受胰岛素治疗的驾驶员队列中有 19%的人报告在驾驶时出现低血糖。确定的危险因素和收集的数据有助于我们更好地开展患者教育。
