Should persons with diabetes be licensed to drive trucks?—Risk management
Abstract
How should a regulatory agency interpret a risk analysis that concludes there is a small increase in risk? The agency must decide on behalf of society whether the increased risk is large enough to justify banning the risky activity or taking some other step to lessen the risks. In a companion paper (Songer et al.), we conclude that licensing insulin using persons to drive commercial motor vehicles in interstate commerce would result in 42 additional crashes each year. Here we address risk management issues by interpreting the number of additional crashes and the relative risks of the prospective handicapped drivers. Are the number of additional crashes (42) significant? Is the increase in the annual crash risk (from 0.00785 to 0.032 for non-insulin dependent and 0.048 for insulin dependent persons) significant? Are the relative risks significant for all insulin using drivers (4.7)? For drivers with a history of severe hypoglycemic reactions (19.8)? How should society tradeoff risk increases for increases in opportunity for these handicapped persons? We review other social decisions concerning highway safety: Accepting the increasing risks of letting 16 year olds drive, allowing extremely light cars, allowing some unsafe highways, and allowing extremely unsafe driving conditions at some times of day. We conclude that the additional risks from insulin using persons are well within the current accepted range of risks.(ABSTRACT TRUNCATED AT 250 WORDS)
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Impaired awareness of hypoglycemia has not consistently been associated with an increased risk of car collisions.
“However, impaired awareness of hypoglycemia has not consistently been associated with an increased risk of car collisions (92–95).”
From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [95]
Impaired awareness of hypoglycemia has not consistently been associated with an increased risk of car collisions.
“However, impaired awareness of hypoglycemia has not consistently been associated with an increased risk of car collisions (92 -95).”
From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [95]
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Seaquist, E. R., Anderson, J., Childs, B., Cryer, P., Dagogo-Jack, S., Fish, L., Heller, S. R., Rodriguez, H., Rosenzweig, J., & Vigersky, R. (2013) · Diabetes Care · doi:10.2337/dc12-2480 · Cited by 1,389 · see citing works
Seaquist, E. R., Anderson, J., Childs, B., Cryer, P., Dagogo-Jack, S., Fish, L., Heller, S. R., Rodriguez, H., Rosenzweig, J., & Vigersky, R. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-4127 · Cited by 412 · see citing works
Mechanisms of hypoglycemia unawareness and implications in diabetic patients
Martín-Timón, I. (2015) · World Journal of Diabetes · doi:10.4239/wjd.v6.i7.912 · Cited by 204 · see citing works
- Authors
- Lave, L. B., Songer, T. J., & LaPorte, R. E.
- Affiliations
- Carnegie Mellon University (US)
- University of Pittsburgh (US)
- ORCID
- Songer, Thomas J.
- Venue
- Risk Analysis
- Publisher
- Wiley
- Published
- 1993-06
- Volume
- 13
- Issue
- 3
- Pages
- 327-334
- ISSN
- 0272-4332 (ISSN-L)
- 1539-6924
- OpenAlex
- W2005771384
- Cited by
- 23
- References
- 11
- Citations by year
- 2025: 1 · 2016: 1 · 2015: 3 · 2013: 4 · 2012: 1
- FWCI
- 6.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Risk Analysis (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Traffic and Road Safety
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Risk and Safety Analysis
- Social Sciences › Sociology and Political Science › Risk Perception and Management
- Keywords
- diabetes mellitus, commercial truck drivers, driver licensing, type 1 diabetes, crash risk, risk management, regulatory decision-making, highway safety, hypoglycemia, risk trade-offs, young drivers, light-duty vehicles
- MeSH terms
- Accidents, Traffic, Adolescent, Adult, Automobile Driving, Costs and Cost Analysis, Diabetes Mellitus, Female, Humans, Licensure, Male, Middle Aged, Risk Management, United States
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