Driving Mishaps Among Individuals With Type 1 Diabetes

A prospective study

  1. Daniel J. Cox, PHD1,
  2. Derek Ford, MA1,
  3. Linda Gonder-Frederick, PHD1,
  4. William Clarke, MD1,
  5. Roger Mazze, PHD2,
  6. Katie Weinger, EDD3 and
  7. Lee Ritterband, PHD1
  1. 1University of Virginia Health Sciences Center, Charlottesville, Virginia;
  2. 2International Diabetes Center, Minneapolis, Minnesota;
  3. 3Joslin Diabetes Center, Boston, Massachusetts.
  1. Corresponding author: Daniel J. Cox, djc4f{at}


OBJECTIVE Hypoglycemia-related neuroglycopenia disrupts cognitive-motor functioning, which can impact driving safety. Retrospective studies suggest that drivers with type 1 diabetes experience more collisions and citations than their nondiabetic spouses. We present the first prospective data documenting the occurrence of apparent neuroglycopenia-related driving performance impairments.

RESEARCH DESIGN AND METHODS We completed the initial screening of 452 drivers from three geographically diverse centers who then reported monthly occurrences of driving “mishaps,” including collisions, citations, losing control, automatic driving, someone else taking over driving, and moderate or severe hypoglycemia while driving.

RESULTS Over 12 months, 52% of the drivers reported at least one hypoglycemia-related driving mishap and 5% reported six or more. These mishaps were related to mileage driven, history of severe hypoglycemia, and use of insulin pump therapy.

CONCLUSIONS Many individuals with type 1 diabetes report hypoglycemia-related driving events. Clinicians should explore the recent experiences with hypoglycemia while driving and the risk of future events.


  • Clinical trial reg. no. NCT00191178,

  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received September 2, 2008.
    • Accepted July 28, 2009.
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