Do You Agree That Tight Blood Sugar Control Can Lead to Increased Risk of Car Crashes?

A new study says that people with diabetes that maintain tigher blood sugar control are at a greater risk of having a car crash. I want to know if you agree or disagree with with this study's findings

The study suggests that people with tightly controlled diabetes are more likely to have hypoglycemic events leading to loss of consciousness or dizzyness, which can contribute to or cause a crash. We ran an about the study on Diabetes news Hound. Check it out here: Car Crash Risk Greater for Diabetics with Tight Blood Sugar Control

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I find that this could possibly be true. My honeymoon has ended which has resulted in higher blood sugars over the past month, which I am taking care of on Thursday when I go to see my endo. I believe that because my blood sugars have been higher I notice my low blood sugars better then when I was under more control. I guess the best way to avoid blood sugar dropping during driving, check often if you are driving far, and always carry snacks, we all know this :)

Not a very sound study by their own admission.  Taking a blanket statistic and applying it to accidents does not truly quantify the results.  I believe if there were to be a study conducted of diabetics with high A1C levels, there could possibly be comparable results to that of the results from this study. 

I found that article ridiculous and bogus. People with tighter control on their numbers dont have lows and highs that would cause accidents. It has nothing to do with car crashes in my opinion.

For a person who recently took herself off the road due to diabetes, here is my take.

Short version: I got out of college, and fought for 6 months to get health insurance in NY. I finally have it, and in the process of find an endcronologist (one that could see me rather soon, I needed new insulin prescriptions..) my primary care doctor stepped in. My A1C was so high, he jacked up my insulin - but only my 24 hour insulin. Slowly increased the dosage every night of my 24 hour insulin. I woke up every morning feeling like I was hit by a truck but my bloodsugar was high - not low. I had issues getting up. My boyfriend tried and failed to wake me up one night when I was panting and grasping his hand so tightly to my body he had to pry it out of my hands, leaving finger marks on my arm the next morning. Needless to say, I didn't go to the full dosage, but driving every morning I felt fuzzy and shaky. I noticed I was having a really hard time paying attention. Eventually, I rolled into a car coming off an on ramp on the way to work. The next day, I found an emergency endocrinologist appointment through the primary care doctor who was acting as my endo.

The Endo helped me fix my insulin problem. He was so pissed that my primary and tried to manage my diabetes by just raising the 24 hour insulin (which, as it turns out, Levemir is not 24 hour insulin. I now take it twice a day and POOF high blood sugars toward the end of the day are normalized.) I now take 15 units of levemir every 12-14 hours - and my bloodsugars are in the 130 range for the last week. (my primary wanted me taking a totally of 40 units before bed... I only took it up to 36.)

Moral of the story, GETTING a tighter control on your diabetes can lead to an increase of car crashes. Like, for example, someone changes your insulin. But if you already have good control of this disease, just test before you drive and make sure you have snacks, and you should be fine.

I definitely agree that the proportion of people with diabetes at risk of going low is higher in those with lower A1C's compared to those with higher A1C's, however, that is simply a correlation. Having a lower A1C does not  put one at risk of being in an accident. Being a person who goes low more often does. Just because there is a correlation between the two, it does not mean causation. 

There is a study that was done in Type 2 diabetics (I think it was called the ACCORD study), which measured heart attack rates and death rates in two groups, one that kept their A1C values below 6% and another group that was above 7%.  Obviously, we'd all say less than 6% is better than greater than 7%, but they actually found that death rates were higher in the below 6% A1C group.  The results were so clear that they actually had to stop the study.

We can't necessarily translate these data to type 1 diabetics, but it goes to show that avoiding small spikes of high BG at the expense of suffering the consequences of constant low BG isn't always worth it.  I try to keep my A1C >6% but <6.5%, and I'm most happy emotionally and mentally with this range.  I'd probably have slightly better physical outcomes with <6% A1C, but the end result honestly doesn't really justify the means.  I'd rather be happy living my life than be miserable extending my life expectancy by 5 years.

Oh and by the way, I feel MOST terrible emotionally and physically when my A1C is above this range.  Especially when it was ~13% when I was diagnosed.  My point is, don't overdo it.  Some health care providers will want your A1C to be lower and lower without really reading the literature.  <6.5% is a great goal.  <6% or <5.5% is a little bit overboard, in my opinion.

Oh and one other thing.  A good friend of mine got in a car crash after starting a new exercise regimen and wasn't aware how low her BG was before she started driving.  So, if you drastically change any part of your diabetes management, be aware of your lows!