[Hypoglycaemia unawareness: judge driving ability prudently].
نویسنده
چکیده
Several factors can influence the ability to drive by patients with diabetes mellitus. The most important factor would be hypoglycaemia. It seems logical that hypoglycaemia unawareness would be an important risk factor for accidents. However, in everyday practice, hypoglycaemia-related accidents are rare. Moreover, it seems that only a small subset of people with diabetes is responsible for the overall slightly elevated risk of car accidents. It appears that not hypoglycaemia unawareness itself is a risk factor, but primarily a history of previous hypoglycaemia-related accidents. Although ascertaining hypoglycaemia awareness currently seems the most suitable method for the assessment of driving ability, this may not be fair. In the future, we hope to have better methods of assessing the risk of accidents. Until that time, we should apply current law prudently, and mainly preclude from driving those diabetic patients who have experienced loss of consciousness or have needed outside help due to hypoglycaemia.
منابع مشابه
Hypoglycaemia unawareness.
Hypoglycaemia is the most frequent and serious complication of insulin therapy and is three times more common in those who are intensively treated. Impaired awareness of hypoglycaemia is a major limitation to achieving tight diabetes. Asymptomatic biochemical hypoglycaemia occurs more frequently during routine blood glucose monitoring and this should alert the clinician that the individual is d...
متن کاملUnawareness of hypoglycaemia and inadequate hypoglycaemic counterregulation: no causal relation with diabetic autonomic neuropathy.
OBJECTIVE To examine the traditional view that unawareness of hypoglycaemia and inadequate hypoglycaemic counterregulation in insulin dependent diabetes mellitus are manifestations of autonomic neuropathy. DESIGN Perspective assessment of unawareness of hypoglycaemia and detailed assessment of autonomic neuropathy in patients with insulin dependent diabetes according to the adequacy of their ...
متن کاملPathophysiology and management of recurrent hypoglycaemia and hypoglycaemia unawareness in diabetes.
Iatrogenic hypoglycaemia is a well-known complication of insulin therapy in patients with diabetes mellitus and a limiting factor for glycaemic control. In a setting of endogenous insulin deficiency (type 1 and advanced type 2 diabetes), one episode of hypoglycaemia reduces both counterregulatory hormone responses to and subjective awareness of subsequent hypoglycaemia, thus impairing physiolog...
متن کاملReduced sensitivity to beta-adrenoceptor stimulation and blockade in insulin dependent diabetic patients with hypoglycaemia unawareness.
Nine IDDM-patients with hypoglycaemia unawareness, seven IDDM-patients with hypoglycemia awareness and a control group of nine healthy persons were included in this study. The patients were recruited from the medical out-patients' department of the University Hospital of Tromsø. The pathophysiological changes which cause hypoglycaemia unawareness are today not clear. Reduced peripheral tissue s...
متن کاملRisk for severe hypoglycaemia with unawareness in GH-deficient patients during the insulin tolerance test.
OBJECTIVE The insulin tolerance test (ITT) has been suggested as the gold standard for diagnosing GH deficiency (GHD). The ITT is, however, potentially hazardous. Glucose monitoring during the ITT varies between centres and there is surprisingly little information on the actual level of blood glucose nadir and the duration of hypoglycaemia in patients undergoing the ITT. The aim of the present ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Nederlands tijdschrift voor geneeskunde
دوره 155 48 شماره
صفحات -
تاریخ انتشار 2011