{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T03:33:48Z","timestamp":1761708828519},"reference-count":15,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,2,28]],"date-time":"2013-02-28T00:00:00Z","timestamp":1362009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Recurrent severe hypoglycaemia in a patient with diabetes is strongly associated with a crash risk while driving. To help ensure road safety, recent changes were made to European Union driving regulations for patients with diabetes. These included the recommendation that more than one episode of severe hypoglycaemia within 12\u00a0months would lead to the loss of a driving licence. This study has assessed the impact of this regulation if applied to patients who participated in the Diabetes Control and Complications Trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients in the Diabetes Control and Complications Trial were assumed to be drivers. Repeated hypoglycaemic episodes within a year were determined during the mean 6.5\u00a0years of the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1441 patients in the Diabetes Control and Complications Trial, 439 (30%) had more than one severe hypoglycaemic episode during a 12\u2010month period of their study participation. Amongst the study groups, 312\/711 (44%) of intensively treated and 127\/730 (17%) of conventionally treated patients would have lost their licence at some point during the trial. The risk of licence loss increased with lower mean HbA<jats:sub>1c<\/jats:sub>, longer duration of diabetes and younger age (all <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>More than one episode of severe hypoglycaemia within a year was a frequent event in subjects in the Diabetes Control and Complications Trial, especially in intensively treated patients. If applied to current practice, improving road safety through these changes to European Union regulations could have a substantial impact on drivers who have Type\u00a01 diabetes. This emphasizes the need to take into account the potential effects of severe hypoglycaemia in those who rely on a driving licence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.12075","type":"journal-article","created":{"date-parts":[[2012,12,6]],"date-time":"2012-12-06T10:51:24Z","timestamp":1354791084000},"page":"616-619","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Implications of new European Union driving regulations on patients with Type 1 diabetes who participated in the Diabetes Control and Complications Trial"],"prefix":"10.1111","volume":"30","author":[{"given":"E. S.","family":"Kilpatrick","sequence":"first","affiliation":[{"name":"Department of Clinical Biochemistry Hull Royal Infirmary Hull UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. S.","family":"Rigby","sequence":"additional","affiliation":[{"name":"Academic Department of Cardiology University of Hull Hull UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. E.","family":"Warren","sequence":"additional","affiliation":[{"name":"Macleod Diabetes and Endocrinology Centre Royal Devon and Exeter Hospital Exeter UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. L.","family":"Atkin","sequence":"additional","affiliation":[{"name":"Department of Diabetes Hull York Medical School Hull UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,2,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pdi.1638"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.23.2.163"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-1510"},{"key":"e_1_2_8_5_1","first-page":"26","article-title":"Commission Directive 2009\/112\/EC of 25 August 2009 amending Council Directive 91\/439\/EEC on driving licences","volume":"52","author":"European Union (EU","year":"2009","journal-title":"OJL"},{"key":"e_1_2_8_6_1","first-page":"31","article-title":"Commission Directive 2009\/113\/EC of 25 August 2009 amending Directive 2006\/126\/EC of the European Parliament and of the Council on driving licences","volume":"52","author":"European Union (EU","year":"2009","journal-title":"OJL"},{"key":"e_1_2_8_7_1","unstructured":"Department for Transport.Proposals to Amend Driving Licence Standards for Vision Diabetes and Epilepsy Annex\u00a0III to Directive 91\/439\/EEC. Annex A Impact Assessment for Proposals to Amend Driving Licence Standards for Diabetes. Available athttp:\/\/www.dft.gov.uk\/dvla\/consultations.aspxLast accessed 6 October 2012."},{"key":"e_1_2_8_8_1","unstructured":"Diabetes UK.Response to the Proposal to Amend Driving Licence Standards for Vision Diabetes and Epilepsy. Annex\u00a03 to Directive 91\/439\/EEC and 2006\/126\/EC. Available athttp:\/\/www.diabetes.org.uk\/About_us\/Our_Views\/Consultations\/Past_responses\/DVLA&#x2013;Consultation-on-amending-medical&#x2013;driving-licence-standards\/Last accessed 6 October 2012."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199309303291401"},{"key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"271","DOI":"10.2337\/diab.46.2.271","article-title":"Hypoglycemia in the Diabetes Control and Complications Trial","volume":"46","author":"DCCT Research Group","year":"1997","journal-title":"Diabetes"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-1579"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003287.pub4"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005613.pub3"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2008.02486.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005103.pub2"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.18.3.361"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.12075","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.12075","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T16:25:53Z","timestamp":1695572753000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.12075"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,2,28]]},"references-count":15,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2013,5]]}},"alternative-id":["10.1111\/dme.12075"],"URL":"https:\/\/doi.org\/10.1111\/dme.12075","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,2,28]]},"assertion":[{"value":"2012-06-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-11-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-02-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}