Altered accelerator pedal control in a driving simulator in people with diabetic peripheral neuropathy

Perazzolo, Monica; Reeves, Neil D.; Bowling, Frank L.; Boulton, Andrew J.M.; Raffi, Milena; Marple‐Horvat, D. E.

doi:10.1111/dme.13957

Cited by 10 publications

(3 citation statements)

References 25 publications

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“…Patients with DPN and prior lower-extremity amputations have a 50% higher risk for losing a second limb within the next 2 years and 5-year survival rates that are substantially lower than age-and sexmatched patients with diabetes without DPN (1)(2)(3). DPN has multiple other consequences, such as major impact on impaired daily function through small-and large-nerve fiber dysfunction, as well as loss of sensory perception, including proprioception, temperature discrimination, and pain, all of which ultimately lead to unsteadiness; recurrent minor injuries, with an increased risk of falls and fractures (1,4); impact on daily function (1,4); impaired control of the accelerator pedal while driving (5); poor oral health (6); and poor quality of life (1,7). Thus, the clinical and socioeconomic costs of DPN are staggering.…”

mentioning

confidence: 99%

The Contemporary Prevalence of Diabetic Neuropathy in Type 1 Diabetes: Findings From the T1D Exchange

Mizokami-Stout

Foster

et al. 2020

Diabetes Care

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To evaluate the contemporary prevalence of diabetic peripheral neuropathy (DPN) in participants with type 1 diabetes in the T1D Exchange Clinic Registry throughout the U.S. RESEARCH DESIGN AND METHODSDPN was assessed with the Michigan Neuropathy Screening Instrument Questionnaire (MNSIQ) in adults with ‡5 years of type 1 diabetes duration. A score of ‡4 defined DPN. Associations of demographic, clinical, and laboratory factors with DPN were assessed. RESULTSAmong 5,936 T1D Exchange participants (mean 6 SD age 39 6 18 years, median type 1 diabetes duration 18 years [interquartile range 11, 31], 55% female, 88% non-Hispanic white, mean glycated hemoglobin [HbA 1c ] 8.1 6 1.6% [65.3 6 17.5 mmol/mol]), DPN prevalence was 11%. Compared with those without DPN, DPN participants were older, had higher HbA 1c , had longer duration of diabetes, were more likely to be female, and were less likely to have a college education and private insurance (all P < 0.001). DPN participants also were more likely to have cardiovascular disease (CVD) (P < 0.001), worse CVD risk factors of smoking (P 5 0.008), hypertriglyceridemia (P 5 0.002), higher BMI (P 5 0.009), retinopathy (P 5 0.004), reduced estimated glomerular filtration rate (P 5 0.02), and Charcot neuroarthropathy (P 5 0.002). There were no differences in insulin pump or continuous glucose monitor use, although DPN participants were more likely to have had severe hypoglycemia (P 5 0.04) and/or diabetic ketoacidosis (P < 0.001) in the past 3 months. CONCLUSIONSThe prevalence of DPN in this national cohort with type 1 diabetes is lower than in prior published reports but is reflective of current clinical care practices. These data also highlight that nonglycemic risk factors, such as CVD risk factors, severe hypoglycemia, diabetic ketoacidosis, and lower socioeconomic status, may also play a role in DPN development.Diabetic neuropathy is a prevalent complication in patients with diabetes and a major cause of morbidity and mortality (1). Among the various forms of diabetic neuropathy, distal symmetric polyneuropathy (DPN) and diabetic autonomic neuropathies are by far the most studied (1).

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confidence: 99%

The Contemporary Prevalence of Diabetic Neuropathy in Type 1 Diabetes: Findings From the T1D Exchange

Mizokami-Stout

Foster

et al. 2020

Diabetes Care

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“…As a result of reduced muscle strength, Restrictions in the neck, shoulder, and wrist movements can limit vision and the ability to control the steering wheel. Sensory and/or motor neuropathy is common in older adults and may impair brake and accelerator pedal use [43].…”

Section: Discusssionmentioning

confidence: 99%

Older patients’ driving safety with the help of DRIVING SIMULATOR: Which cognitive test can predict better driving safety?

et al. 2023

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Introduction: Being able to drive is an important parameter of independence and self-sufficiency. The continued use of cars, which plays an important role in maintaining the mobility of the older individuals, is very important for the protection of the individual’s activity performance. Methods: Driving skills of 31 participants were tested with the help of a driving simulator and cognitive tests were applied to each participant. The study was aimed to reveal the relationship between the cognitive functions and safe driving skills of older patients using the driving simulator and to determine the cognitive test that predicts the safe driving skill best. Results: 31 participants was included in the study. All participants were male. The average age was 72.5±6.The median of MMSE was 29 (IQR; 28-30),the mean of MOCA was 25.52±2.6,the mean value of QMCI was 62.68±9.57, the median of trail making test A was 42.5 sec(22-97), and the median of trail making test B was 98.31 sec(38-313).MOCA test score correlated positively with “the skills expected before starting the vehicle “and driving parameters on the highway(“p: 0.0024, r:0.46”;”p:0.0024, r:0.46”,respectively).The QMCI test was found to have a statistically positive and significant correlation with operational skills and the skills expected before starting the vehicle(“p:0.041, r:0.43”; “p:0.015 r:0.50”,respectively).When the factors affecting operational skills and safe driving skills were analyzed by linear regression analysis, both skills were influenced by the QMCI-orientation step(p:0.001;CI:1.59-3.9). Conclusion: In our study, it is shown that driving skills decrease with aging. QMCI and MOCA, which are easy to apply in clinical practice, will be useful in patients driving vehicles aged 65 and over with the demonstration of a significant relationship with total driving score, safe driving and operational skills.

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“…In addition, the road traffic crash rate is largely influenced by young people, particularly male drivers, a population in which the prevalence of diabetes is considerably lower than in older age groups [ 7 ]. Nonetheless, simulation studies have clearly demonstrated that people with diabetes tend to exhibit poor performance in muscle functioning, ankle proprioception, and accelerator pedal control [ 8 ]. Moreover, a study found that compared to individuals without diabetes who had equal confidence in their driving skills, patients with type 2 diabetes exhibited worse driving performance, as evidenced by a larger centerline deviation, a longer brake reaction time, and a shorter minimum time to collision [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Type 2 diabetes mellitus increases the severity of non-fatal injuries, but not the risk of fatal injuries, among driver victims of motor vehicle crashes in Taiwan

Chang¹,

Hou²,

Li³

2022

Epidemiol Health

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Altered accelerator pedal control in a driving simulator in people with diabetic peripheral neuropathy

Cited by 10 publications

References 25 publications

The Contemporary Prevalence of Diabetic Neuropathy in Type 1 Diabetes: Findings From the T1D Exchange

The Contemporary Prevalence of Diabetic Neuropathy in Type 1 Diabetes: Findings From the T1D Exchange

Older patients’ driving safety with the help of DRIVING SIMULATOR: Which cognitive test can predict better driving safety?

Type 2 diabetes mellitus increases the severity of non-fatal injuries, but not the risk of fatal injuries, among driver victims of motor vehicle crashes in Taiwan

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