Liu Difei, Chihuri Stanford, Andrews Howard F, Betz Marian E, DiGuiseppi Carolyn, Eby David W, Hill Linda L, Jones Vanya, Mielenz Thelma J, Molnar Lisa J, Strogatz David, Lang Barbara H, Li Guohua
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, 622 West 168th Street, New York, NY, PH5-534, 10032, USA.
Inj Epidemiol. 2024 Jun 5;11(1):22. doi: 10.1186/s40621-024-00508-2.
Diabetes mellitus (DM) can impair driving safety due to hypoglycemia, hyperglycemia, diabetic peripheral neuropathy, and diabetic eye diseases. However, few studies have examined the association between DM and driving safety in older adults based on naturalistic driving data.
Data for this study came from a multisite naturalistic driving study of drivers aged 65-79 years at baseline. Driving data for the study participants were recorded by in-vehicle recording devices for up to 44 months. We used multivariable negative binomial modeling to estimate adjusted incidence rate ratios (aIRRs) and 95% confidence intervals (CIs) of hard braking events (HBEs, defined as maneuvers with deceleration rates ≥ 0.4 g) associated with DM.
Of the 2856 study participants eligible for this analysis, 482 (16.9%) reported having DM at baseline, including 354 (12.4%) insulin non-users and 128 (4.5%) insulin users. The incidence rates of HBEs per 1000 miles were 1.13 for drivers without DM, 1.15 for drivers with DM not using insulin, and 1.77 for drivers with DM using insulin. Compared to drivers without DM, the risk of HBEs was 48% higher for drivers with DM using insulin (aIRR 1.48; 95% CI: 1.43, 1.53).
Older adult drivers with DM using insulin appear to be at increased proneness to vehicular crashes. Driving safety should be taken into consideration in DM care and management.
糖尿病（DM）可因低血糖、高血糖、糖尿病周围神经病变和糖尿病眼病而损害驾驶安全。然而，基于自然驾驶数据，很少有研究探讨老年人中糖尿病与驾驶安全之间的关联。
本研究的数据来自一项针对65 - 79岁基线驾驶员的多地点自然驾驶研究。研究参与者的驾驶数据由车载记录设备记录长达44个月。我们使用多变量负二项式模型来估计与糖尿病相关的急刹车事件（HBEs，定义为减速率≥0.4g的操作）的调整发病率比（aIRRs）和95%置信区间（CIs）。
在符合此分析条件的2856名研究参与者中，482人（16.9%）在基线时报告患有糖尿病，其中354人（12.4%）未使用胰岛素，128人（4.5%）使用胰岛素。每1000英里急刹车事件的发生率，未患糖尿病的驾驶员为1.13，患糖尿病但未使用胰岛素的驾驶员为1.15，患糖尿病且使用胰岛素的驾驶员为1.77。与未患糖尿病的驾驶员相比，患糖尿病且使用胰岛素的驾驶员发生急刹车事件的风险高48%（aIRR 1.48；95% CI：1.43，1.53）。
使用胰岛素的老年糖尿病驾驶员似乎更容易发生车祸。在糖尿病的护理和管理中应考虑驾驶安全。
