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Severe hypoglycemia reports in EU drop with driver's license legislation
Reports of severe hypoglycemia by patients with type 1 diabetes in the European Union dropped after implementation of legislation that entails driver’s license withdrawal in the case of recurring episodes over 1 year, according to research published in Diabetes Care.
The safety of affected patients could be impaired, and the general traffic safety unintentionally and paradoxically reduced, as a result of concealed severe hypoglycemia, according to researchers in Denmark.
“Rates of severe hypoglycemia reported by patients with type 1 diabetes in routine clinical practice are immediately halved following implementation of the new EU directive on driver’s licensing,” the researchers wrote.
Ulrik Pedersen-Bjergaard, MD, of the University of Copenhagen, Denmark, and colleagues recruited 309 patients with type 1 diabetes from the Nordsjællands University Hospital Hillerød outpatient clinic to investigate the impact of the stricter legislation.
Using medical records from 2010 to 2012, the researchers quantified yearly severe hypoglycemic events, as defined by the need for treatment assistance from another person, and retrospectively reported the numbers in an anonymous questionnaire. Data from 2012 was compared with those from 2010 and 2011 and with data from the questionnaire.
The rates of severe hypoglycemia reported had decreased 55% in 2012 compared with the prior years (P=.034); the proportion of patients reporting recurrent episodes dropped from 5.6% to 1.5% (P=.014). Compared with anonymous reporting, the rate of severe hypoglycemia in 2012 was 70% lower (P<.001).
The researchers acknowledged the importance of the legislation but expressed concern about the threat it may present to physician-patient relationships, particularly their maintenance to improve long-term outcomes.
“Information about severe hypoglycemia in medical records only represent the tip of the iceberg, and it is therefore of utmost importance to improve the dialogue with the patients about this major clinical problem and its prevention,” the researchers wrote.
Disclosure: Pedersen-Bjergaard reports various financial ties with AstraZeneca/Bristol-Myers Squibb, Novo Nordisk and Sanofi Aventis. Please see the study for a full list of additional researchers’ financial disclosures.