背景:糖尿病(DM)会由于低血糖而损害驾驶安全性,高血糖症,糖尿病周围神经病变,和糖尿病眼病。然而,很少有研究基于自然驾驶数据对老年糖尿病与驾驶安全之间的关联进行研究.
方法:本研究的数据来自对基线年龄为65-79岁的驾驶员进行的多站点自然驾驶研究。研究参与者的驾驶数据由车载记录设备记录长达44个月。我们使用多变量负二项模型来估计硬制动事件的调整发生率比(aIRRs)和95%置信区间(CIs)(HBEs,定义为与DM相关的减速率≥0.4g)的机动。
结果:在符合本分析条件的2856名研究参与者中,482(16.9%)报告基线时患有DM,包括354名(12.4%)非胰岛素使用者和128名(4.5%)胰岛素使用者。没有DM的驾驶员每1000英里的HBEs发生率为1.13,1.15对于DM未使用胰岛素的驾驶员,使用胰岛素的DM驾驶员为1.77。与没有DM的驾驶员相比,使用胰岛素的DM驾驶员的HBEs风险高出48%(aIRR1.48;95%CI:1.43,1.53).
结论:使用胰岛素的成年DM驾驶员似乎更容易发生车辆碰撞。在DM护理和管理中应考虑驾驶安全。
BACKGROUND: Diabetes mellitus (DM) can impair driving safety due to hypoglycemia, hyperglycemia, diabetic peripheral neuropathy, and diabetic eye diseases. However, few studies have examined the association between DM and driving safety in older adults based on naturalistic driving data.
METHODS: Data for this study came from a multisite naturalistic driving study of drivers aged 65-79 years at baseline. Driving data for the study participants were recorded by in-vehicle recording devices for up to 44 months. We used multivariable negative binomial modeling to estimate adjusted incidence rate ratios (aIRRs) and 95% confidence intervals (CIs) of hard braking events (HBEs, defined as maneuvers with deceleration rates ≥ 0.4 g) associated with DM.
RESULTS: Of the 2856 study participants eligible for this analysis, 482 (16.9%) reported having DM at baseline, including 354 (12.4%) insulin non-users and 128 (4.5%) insulin users. The incidence rates of HBEs per 1000 miles were 1.13 for drivers without DM, 1.15 for drivers with DM not using insulin, and 1.77 for drivers with DM using insulin. Compared to drivers without DM, the risk of HBEs was 48% higher for drivers with DM using insulin (aIRR 1.48; 95% CI: 1.43, 1.53).
CONCLUSIONS: Older adult drivers with DM using insulin appear to be at increased proneness to vehicular crashes. Driving safety should be taken into consideration in DM care and management.