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Summary:The primary objective of this systematic review was to address the question, "Are drivers with diabetes mellitus at greater risk for a motor vehicle crash than comparable drivers without the disease?" and secondarily, to address the question, "Are insulin-treated diabetics at higher risk for crash?" Our searches identified 16 articles that addressed these questions. An assessment of study quality of the included studies found them to be in the low-to-moderate range. While attempts were made to control for differences in the characteristics of individuals that may confound the relationship between diabetes and crash risk in all included studies, most failed to control for exposure. A random-effects metaanalysis found that individuals with diabetes have a 19% increased risk for a motor vehicle crash when compared to similar individuals without diabetes. We found no compelling evidence to suggest that insulin-treated individuals are at higher risk for motor vehicle crash than individuals with diabetes not being treated with insulin. We discuss the implications of these findings.

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