Does gender affect the driving performance of young patients with diabetes?

Recent evidence suggests that poor glycemic control among young patients with type 1 diabetes mellitus (T1DM) has negative cognitive and physical effects, whose extent is gender-dependent. For example, female patients with diabetes present more physical and cognitive limitations than male patients in terms of cognitive adjustment, quality of decision making, and functioning. Studies about traffic safety report that diabetic drivers are at increased risk of being involved in road crashes, especially when driving in a state of hypoglycemia under which their blood glucose level is too low. We have recently demonstrated that acute hyperglycemia (when the blood glucose level is too high) can also lead to poor driving performance among T1DM young adult patients. Against this background, the objective of the present study was to find out whether gender affects the driving performance of young drivers with diabetes. Twenty-six T1DM drivers participated in a counterbalanced crossover experiment. While being monitored by an eye tracker, they drove a driving simulator and twice navigated through the nine hazardous scenarios: once under a normal blood glucose (euglycemia) level and once high blood glucose (hyperglycemia) level. The first main result is that young female drivers are more affected by diabetes than young male drivers, regardless of momentary glycemic changes. The second main result is that poor glycemic control substantially deteriorates hazard perception and driving performance of young males with diabetes. Thus, it is argued that an uncontrolled state of a high blood glucose level may be more hazardous for young males with diabetes since it negatively impacts their driving performance.

Driver distraction and its effects on partially automated driving performance: A driving simulator study among young-experienced drivers.

Drivers of partially automated vehicles (PAVs) are relieved from parts of the driving tasks allocated to the automated driver. Ironically, these drivers are obligated to continuously monitor the driving task at all times and keep their attention on the roadway. This reduction in the driving task's demands and cognitive workload may encourage drivers to engage with non-driving related tasks (NDRT), which may impair drivers' awareness of the road environment and, as a result, compromise safety. This study examined how engagement with a visual-manual NDRT affects the driving performance of PAV drivers. Thirty-seven participants were randomly assigned to one of two experimental conditions in a driving simulator. Each consisted of two simulated drives. The first experimental condition included one drive under manual driving conditions and another under partially automated driving conditions (i.e., L2). Both drives had no NDRT involved. The second experimental condition included one drive under L2 without an NDRT and one drive under L2, including engagement with an NDRT. Participants' eye movements and heart rate were recorded throughout the experiment. Across various measures, the findings showed that under L2 driving conditions, engagement with an NDRT impairs driving performance in two primary aspects: (1) drivers were less aware of road hazards, and (2) their mental workload was higher when they engaged with an NDRT. In addition, the findings reveal that for drivers engaged with an NDRT, the attentional time-sharing strategy between the NDRT and the roadway monitoring task affected the probability of identifying a hazard. This study shows the adverse effects of engagement with an NDRT under L2 driving conditions on driving performance. Future studies should examine different interventions to mitigate these effects, assuring that drivers are constantly aware of the roadway environment.

Acute hyperglycaemia can impair driving skill in young type 1 diabetes mellitus patients.

AIM: Drivers with diabetes are at increased risk of being involved in road accidents. Therefore, this study aimed to evaluate the effects of acute hyperglycaemia (AH) compared with euglycaemia on driving ability in patients with type 1 diabetes mellitus (T1DM). METHODS: Eighteen drivers with T1DM were asked to navigate twice through nine hazardous scenarios, using a driving simulator, during euglycaemia and then again during AH (mean blood glucose: 138 ± 34 mg/dL and 321 ± 29 mg/dL, respectively) in a counterbalanced crossover study. Driving performance was continually monitored for driving speed, steering wheel angle, acceleration, and location and velocity of other vehicles and obstacles, with drivers wearing a mobile head-mounted eye-tracking system. RESULTS: The main findings were that, during AH, participants were less likely to identify a hazard [probability of identification (POI): 0.5725 ± 0.5], glanced fewer times at the hazard (3.24 ± 5.9), maintained shorter headway (between-vehicle) distance (mean: 40.87 ± 20.15 m) and had an increased number of braking events per km driven (6.69 ± 5.20) compared with driving during euglycaemia (POI: 0.733 ± 0.4; number of glances: 3.69 ± 6.99; headway distance: 50.46 ± 26.2 m; number of braking events per km driven: 4.31 ± 3.87; P < 0.05 for all parameters). CONCLUSION: This study provides evidence that AH impairs driving performance in young T1DM patients by demonstrating the negative effects of AH on both hazard perception and speed management.