Hypoglycemia unawareness: oordeel bewust over rijvaardigheid

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.

Conflict of interest: Dr. A.D.M. Stork received remuneration for consulting from MSD and Novartis on matters pertaining to non-diabetes-related antihypertensive and lipid-lowering medications, for contributing to various pharmacotherapeutic discussions from different groups of general practitioners, as well as financial support for various trips to conferences. Financial support for this article: none declared.