Diabetic peripheral neuropathy can impair driving performance
Motorists with diabetic peripheral neuropathy drive at slower speeds and are at increased risk for losing control of the vehicle compared with adults without peripheral nerve dysfunction; however, these drivers can improve with practice, according to results of a study conducted in the United Kingdom.
“This research lays the foundation for assessment and training within a diabetic clinic to help drivers with neuropathy drive more like someone without the condition,” Monica Perazzolo, a PhD student in the department of biomedical and neuromotor sciences at the University of Bologna in Italy, told Endocrine Today. “Such a science-based intervention could lead to an in-car automated driver assistance system which would help people with diabetic peripheral neuropathy to drive safely for longer, so retaining their personal independence.”
Perazzolo and colleagues assessed ankle and foot strength as well as driving performance in a cohort of 32 licensed drivers in the United Kingdom, with 11 having diabetic peripheral neuropathy (mean age, 67 years; 18.2% women), 10 having diabetes only (mean age, 62 years; 10% women) and 11 having no diabetes (mean age 60 years; 18.2% women). Ankle and foot strength were assessed by testing the planta flexor muscles on a dynamometer footplate that acted similarly to a break pedal. Driving performance was evaluated during two repeated 3.1-mile simulated driving tests.
Participants with diabetic peripheral neuropathy had weaker maximal plantar flexor muscle strength (P < .001) and lower ankle proprioception function, which contributes to more driver errors, (P = .034) compared with those without diabetes. Measures for the group with diabetes but no neuropathy were similar to those for the group without diabetes. The neuropathy group also took longer to build up strength in their foot than those without diabetes (P < .001), and slower speeds were also recorded for those with diabetes (P = .002) compared with those without the condition.
During the first driving test, those with diabetic peripheral neuropathy averaged a speed of 16.53 miles per hour compared to speeds of 20.41 miles per hour by those with diabetes alone and 22.08 miles per hour by those without diabetes (P = 0.48). Speeds increased for all groups in the second test, but those with diabetic peripheral neuropathy still had the slowest speed (18.55 miles per hour) compared with those with diabetes (21.56 miles per hour) and those without diabetes (24.06 miles per hour, P = .042).
Participants with diabetic peripheral neuropathy spent 59.07 seconds in “loss-of-control events” during the first test, which compared with 13.02 seconds and 5.86 seconds in those with diabetes and without diabetes, respectively (P = .04). However, time in “loss-of-control events” was cut to 13.83 seconds during the second drive for drivers with diabetic peripheral neuropathy, which was significantly lower than those without diabetes (P = .049) but not those with diabetes.
“The most immediate solution would be to offer drivers with diabetic peripheral neuropathy driving skill-specific training based on visual feedback,” Perazzolo said. “Beyond this, our findings could inform the design and use of an in-car device that will assist them during driving.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.