Sugar and stops in drivers with insulin-dependent type 1 diabetes

dc.contributor.author Barnwal, Ashirwad
dc.contributor.author Chakraborty, Pranamesh
dc.contributor.author Sharma, Anuj
dc.contributor.author Riera-Garcia, Luis
dc.contributor.author Ozcan, Koray
dc.contributor.author Davami, Sayedomidreza
dc.contributor.author Sarkar, Soumik
dc.contributor.author Rizzo, Matthew
dc.contributor.author Merickel, Jennifer
dc.contributor.department Institute for Transportation
dc.contributor.department Mechanical Engineering
dc.date.accessioned 2024-03-25T18:16:55Z
dc.date.available 2024-03-25T18:16:55Z
dc.date.issued 2022-08
dc.description.abstract Background: Diabetes is a major public health challenge, affecting millions of people worldwide. Abnormal physiology in diabetes, particularly hypoglycemia, can cause driver impairments that affect safe driving. While diabetes driver safety has been previously researched, few studies link real-time physiologic changes in drivers with diabetes to objective real-world driver safety, particularly at high-risk areas like intersections. To address this, we investigated the role of acute physiologic changes in drivers with type 1 diabetes mellitus (T1DM) on safe stopping at stop intersections. <br/> Methods: 18 T1DM drivers (21–52 years, µ = 31.2 years) and 14 controls (21–55 years, µ = 33.4 years) participated in a 4-week naturalistic driving study. At induction, each participant’s personal vehicle was instrumented with a camera and sensor system to collect driving data (e.g., GPS, video, speed). Video was processed with computer vision algorithms detecting traffic elements (e.g., traffic signals, stop signs). Stop intersections were geolocated with clustering methods, state intersection databases, and manual review. Videos showing driver stop intersection approaches were extracted and manually reviewed to classify stopping behavior (full, rolling, and no stop) and intersection traffic characteristics. <br/> Results: Mixed-effects logistic regression models determined how diabetes driver stopping safety (safe vs. unsafe stop) was affected by 1) disease and 2) at-risk, acute physiology (hypo- and hyperglycemia). Diabetes drivers who were acutely hyperglycemic (≥300 mg/dL) had 2.37 increased odds of unsafe stopping (95% CI: 1.26–4.47, p = 0.008) compared to those with normal physiology. Acute hypoglycemia did not associate with unsafe stopping (p = 0.537), however the lower frequency of hypoglycemia (vs. hyperglycemia) warrants a larger sample of drivers to investigate this effect. Critically, presence of diabetes alone did not associate with unsafe stopping, underscoring the need to evaluate driver physiology in licensing guidelines. <br/> Conclusion: This study links acute, abnormal physiologic fluctuations in drivers with diabetes to driver safety based on unsafe stopping at stop-controlled intersections, providing recommendations for clinicians aimed at improving patient safety, fair licensing guidelines, and targets for developing advanced driver assistance systems.
dc.description.comments This is a manuscript of an article published as Barnwal, Ashirwad, Pranamesh Chakraborty, Anuj Sharma, Luis Riera-Garcia, Koray Ozcan, Sayedomidreza Davami, Soumik Sarkar, Matthew Rizzo, and Jennifer Merickel. "Sugar and stops in drivers with insulin-dependent type 1 diabetes." Accident Analysis & Prevention 173 (2022): 106692. doi:10.1016/j.aap.2022.106692. © 2022 Elsevier Ltd. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
dc.identifier.uri https://dr.lib.iastate.edu/handle/20.500.12876/0zEydo9z
dc.language.iso en
dc.publisher Elsevier Ltd.
dc.source.uri https://doi.org/10.1016/j.aap.2022.106692 *
dc.subject.disciplines DegreeDisciplines::Engineering::Civil and Environmental Engineering::Transportation Engineering
dc.subject.disciplines DegreeDisciplines::Engineering::Computational Engineering
dc.subject.disciplines DegreeDisciplines::Medicine and Health Sciences::Medical Specialties::Endocrinology, Diabetes, and Metabolism
dc.subject.keywords naturalistic driving
dc.subject.keywords unsafe stopping
dc.subject.keywords driver risk
dc.subject.keywords type 1 diabetes
dc.subject.keywords hypoglycemia
dc.subject.keywords hyperglycemia
dc.title Sugar and stops in drivers with insulin-dependent type 1 diabetes
dc.type Article
dspace.entity.type Publication
relation.isAuthorOfPublication 717eae32-77e8-420a-b66c-a44c60495a6b
relation.isOrgUnitOfPublication 0cffd73a-b46d-4816-85f3-0f6ab7d2beb8
relation.isOrgUnitOfPublication 6d38ab0f-8cc2-4ad3-90b1-67a60c5a6f59
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