Introduction & Objective: Antidiabetic agents increase the risk of traffic accidents due to hypoglycemia. The continuous glucose monitoring (CGM) system, which has recently seen widespread use, has facilitated the determination of hypoglycemia frequency, including asymptomatic hypoglycemia. However, limited research reports have been available on hypoglycemia while driving determined using CGM.
Methods: Questionnaire surveys and a 4-week blind CGM examination were conducted on patients using insulin who drove three or more times a week and visited the hospital regularly.
Results: Among the 29 participants who responded to the questionnaire, 22 (76%) had experienced hypoglycemia in the past, and 12 (41%) had experienced hypoglycemia while driving. CGM in 28 subjects analyzed indicated that all cases had low glucose levels (<70 mg/dL), with 15 patients (54%) having levels <54 mg/dL. The time below range (TBR) <70 and <54 mg/dL was 5.3% (standard deviation: 6.9%) and 0.8% (1.6%), respectively. Over 90% of those with low glucose levels had asymptomatic hypoglycemia. While driving, 15 (54%) and 1 (4%) patients had experienced glucose levels <70 and <54 mg/dL, respectively. While driving, the TBR <70 and < 54 mg/dL was 3.6% (7.1%) and 0.3% (1.6%), which tended to be lower than that during the whole period. Among the patients who had never reported hypoglycemia while driving in the questionnaire, 8 (53%) had low glucose levels while driving determined via CGM. For those who had and had not previously reported hypoglycemia while driving, the TBR < 70 mg/dL was 5.6% (2.1%) and 2.2% (1.9%), respectively. Moreover, the TBR < 70 mg/dL when awake and asleep was 4.3% (7.1%) and 8.1% (11.5%), respectively.
Conclusion: CGM of patients with diabetes using insulin who drive more than three times a week revealed that all cases had low glucose levels (<70 mg/dL), with half experiencing this while driving.
R. Maeda: Research Support; Abbott. T. Onoue: None. T. Handa: None. T. Kobayashi: None. H. Arima: Research Support; Abbott.
