{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T03:38:55Z","timestamp":1788752335697,"version":"build-2803163510"},"reference-count":54,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,2,17]],"date-time":"2013-02-17T00:00:00Z","timestamp":1361059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:p>\n                    The principal safety concern for driving for people treated with insulin or insulin secretagogues is hypoglycaemia, which impairs driving performance. Other complications, such as those causing visual impairment and peripheral neuropathy, are also relevant to medical fitness to drive. Case control studies have suggested that drivers with diabetes pose a modestly increased but acceptable and measurable risk of motor vehicle accidents compared to non\u2010diabetic drivers, but many studies are limited and of poor quality. Factors which have been shown to increase driving risk include previous episodes of severe hypoglycaemia, previous hypoglycaemia while driving, strict glycaemic control (lower\n                    <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content>\n                    ) and absence of blood glucose monitoring before driving. Impaired awareness of hypoglycaemia may be counteracted by frequent blood glucose testing. The European Union Third directive on driving (2006) has necessitated changes in statutory regulations for driving licences for people with diabetes in all European States, including the\n                    <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>\n                    . Stricter criteria have been introduced for Group 1 vehicle licences while those for Group 2 licences have been relaxed. Insulin\u2010treated drivers can now apply to drive Group 2 vehicles, but in the\n                    <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>\n                    must meet very strict criteria and be assessed by an independent specialist to be issued with a 1\u2010year licence.\n                  <\/jats:p>","DOI":"10.1111\/dom.12071","type":"journal-article","created":{"date-parts":[[2013,1,26]],"date-time":"2013-01-26T06:37:28Z","timestamp":1359182248000},"page":"775-783","source":"Crossref","is-referenced-by-count":52,"title":["Diabetes and driving"],"prefix":"10.1111","volume":"15","author":[{"given":"B.","family":"Inkster","sequence":"first","affiliation":[{"name":"Department of Diabetes Royal Infirmary of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. M.","family":"Frier","sequence":"additional","affiliation":[{"name":"BHF Department for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,2,17]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Britten N. Diabetic driver cleared over blackout crash. Telegraph\u00a02004."},{"key":"e_1_2_8_3_1","unstructured":"Payne S. Protests as death crash diabetic is cleared. The Daily Telegraph\u00a02002."},{"key":"e_1_2_8_4_1","unstructured":"Diabetes UK. Diabetes UK position statement. 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For medical practitioners At a glance guide to the current medical standards of fitness to drive May 2012 incorporating August\/October 2012 amendments. Drivers Medical Group DVLA Swansea 2012. Available from URL:http:\/\/www.dft.gov.uk\/dvla\/medical\/ataglance.aspx."},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.1998.12"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2008.02623.x"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.8.2329"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/pdi.1097"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc05-2232"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2009.02699.x"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2008.02409.x"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2008.02586.x"},{"key":"e_1_2_8_36_1","first-page":"335","article-title":"High risk characteristics for motor vehicle crashes in persons with diabetes by age","volume":"50","author":"Songer TJ","year":"2006","journal-title":"Annu Proc Assoc Adv Automot Med"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/15389588.2012.654411"},{"key":"e_1_2_8_38_1","first-page":"e112","article-title":"Anti\u2010diabetic drug use and the risk of motor vehicle crash in the elderly","volume":"13","author":"Hemmelgarn B","year":"2006","journal-title":"Can J Clin Pharmacol"},{"key":"e_1_2_8_39_1","volume-title":"FMCSA Evidence Report: 2010 Update Diabetes and Commercial Motor Vehicle Driver Safety","author":"Bieber\u2010Tregear M","year":"2011"},{"key":"e_1_2_8_40_1","volume-title":"Impairments, Diseases, Age and their Relative Risks of Accident Involvement: Results from Meta\u2010Analysis","author":"Vaa T","year":"2003"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aap.2005.06.018"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-1510"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-2130"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000192"},{"key":"e_1_2_8_45_1","doi-asserted-by":"crossref","unstructured":"Signorovitch JE Macaulay D Diener M et al. 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Diabetes and Driving in Europe a report of the second European working group on diabetes and driving an advisory board to the driving licence committee of the European Union. 2006."},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/pdi.1671"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.4.637"},{"key":"e_1_2_8_54_1","unstructured":"Driver and Vehicle Licensing Agency (DVLA). INF45 Your photocard driving licence explained. 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