Intermittently scanned continuous glucose monitoring and hypoglycaemia awareness in drivers with diabetes: Insights from the Association of British Clinical Diabetologists Nationwide audit

Mark-Wagstaff, Charlotte; Deshmukh, Harshal; Wilmot, Emma G.; Walker, Neil; Barnes, Dennis; Parfitt, Vernon; Saunders, Simon; Gregory, Rob; Choudhary, Pratik; Patmore, Jane; Walton, Chris; Ryder, Robert E.J.; Sathyapalan, Thozhukat

Abstract

Aim: Frequent hypoglycaemia results in disruption to usual hypoglycaemic autonomic responses leading to impaired awareness of hypoglycaemia, which is associated with an increased risk of severe hypoglycaemia requiring third-party assistance (SH). The UK Driving and Vehicle Licensing Agency (DVLA) does not permit car driving if they have either a complete loss of hypoglycaemia awareness or more than one SH event a year. Methods: The FreeStyle Libre (FSL) Association of British Clinical Diabetologists (ABCD) Nationwide Audit consists of data collected by clinicians during routine clinical work, submitted into a secure web-based tool held within the National Health Service (NHS) N3 network. Analysis of paired baseline and follow-up data for people with type 1 diabetes who also held a driving licence was undertaken. Results: The study consisted of 6304 people who had data recorded about driving status from 102 UK specialist diabetes centres, of which 4218 held a driving licence: 4178 a group 1, standard licence, 33 a group 2, large lorries and buses, seven a taxi licence; 1819 did not drive. Paired baseline and follow-up data were available for a sub-cohort of 1606/4218. At a mean follow-up of 6.9 months [95% CI (6.8, 7.1)], the Gold score had improved (2.3 ± 1.5 vs. 2.0 ± 1.3 p <.001), and the number of people who experienced an SH episode was also significantly lower (12.1% vs. 2.7%, p <.001). Conclusion: This study suggests that intermittently scanned continuous glucose monitoring may improve impaired awareness of hypoglycaemia and reduce the number of people with type 1 diabetes with a driving licence experiencing a severe hypoglycaemic episode.

Citation

Mark-Wagstaff, C., Deshmukh, H., Wilmot, E. G., Walker, N., Barnes, D., Parfitt, V., Saunders, S., Gregory, R., Choudhary, P., Patmore, J., Walton, C., Ryder, R. E., & Sathyapalan, T. (2024). Intermittently scanned continuous glucose monitoring and hypoglycaemia awareness in drivers with diabetes: Insights from the Association of British Clinical Diabetologists Nationwide audit. Diabetes, Obesity and Metabolism, 26(1), 46-53. https://doi.org/10.1111/dom.15283

• Journal Article Type: Article
• Acceptance Date: Aug 28, 2023
• Online Publication Date: Sep 17, 2023
• Publication Date: Jan 26, 2024
• Deposit Date: Sep 9, 2024
• Publicly Available Date: Sep 18, 2024
• Journal: Diabetes, Obesity and Metabolism
• Print ISSN: 1462-8902
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 26
• Issue: 1
• Pages: 46-53
• DOI: https://doi.org/10.1111/dom.15283
• Keywords: Database research; Glycaemic control; Hypoglycaemia; Real-world evidence; Type 1 diabetes
• Public URL: https://hull-repository.worktribe.com/output/4404001