Diabetes and Motor Vehicle Crashes: A Systematic Evidence-Based Review and Meta-Analysis

Abstract

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.

Visual vigilance in drivers with obstructive sleep apnea

“…Although sleep-deprived healthy drivers probably cause most of these crashes [2], many are the result of drivers with sleep disorders, such as obstructive sleep apnea (OSA). OSA drivers may be especially unsafe, as recent meta-analyses have shown a mean crash risk ratio of 2.72, indicating that these individuals have a 172% greater chance of a crash relative to the general population [3, 4]. Motor vehicle crashes from improperly treated OSA lead to enormous suffering and annual costs that may exceed $11 billion [3].…”

Useful Field of View Impairments in Drivers with Obstructive Sleep Apnea

“…Drivers with obstructive sleep apnea (OSA) have a crash risk that is more than twice that of the general population (Tregear et al, 2008). Sleepiness-related cognitive impairments, which reduce driver performance and increase the likelihood of driver errors that result in crashes, may play a key role.…”

Diabetes and Driving

“…Yet, when the type of diabetes is controlled for, insulin therapy per se has not been found to be associated with increased driving risk (3,16,17). While impaired awareness of hypoglycemia has been found to relate to increased incidence of motor vehicle crashes in some studies (12), it has not been found to be a relevant variable in other studies (4,7,23).…”