Professional Section Quarterly - Winter 2012 - (Page 2)

Clinical News cont. from page 1 continued from page 1 having a motor vehicle accident has been estimated to be 12–19% higher for people with diabetes than for the general population, society does not restrict driving by categories of people with much higher risk ratios for collisions, such as teenage males and individuals with attention deficit/hyperactivity disorder. “If society tolerates these conditions, it would be unjustified to restrict the driving privileges of an entire class of individuals who are at much lower risk, such as drivers with diabetes,” the statement argues. “However,” it also says, “just as there are some patients with conditions that increase their risk of incurring driving mishaps, such as unstable coronary heart disease, obstructive sleep apnea, epilepsy, Parkinson’s disease, or alcohol and substance abuse, there are also some drivers with diabetes that have a higher risk for driving mishaps. The challenges are to identify high-risk individuals and develop measures to assist them to lower their risk for driving mishaps.” mendations, and a table of evidence for changes made to the recommendations since last year. The entire supplement is freely available to search, download, and view on a mobile device. Also, new for 2012, readers are invited to comment on the Clinical Practice Recommendations through an online form. To access these resources, please visit pro fessional.diabetes.org/CPR_Search. ADA Journals Go Mobile Identifying High-Risk Drivers A recent history of severe hypoglycemia, regardless of the type of diabetes or the treatment used, seems to be “the single most significant factor associated with driving collisions for drivers with diabetes,” the statement concludes. Retinopathy, peripheral neuropathy, and obstructive sleep apnea are also cited as conditions that can affect the driving ability of people with diabetes. The position statement recommends that states use a standardized questionnaire to help identify potentially at-risk drivers with diabetes who may require further evaluation. The statement adds that such evaluation must include an assessment by the driver’s treating physician or another diabetes specialist, and specifies what information should be provided to licensing agencies by evaluating physicians. To ensure that state licensing agencies make informed, individualized licensing decisions for drivers with diabetes, each such agency should have a medical advisory board with either a permanent member or a consultant with expertise in diabetes, the statement urges. The statement does not endorse mandatory physician reporting of at-risk drivers with diabetes, but rather recommends that physicians “be permitted to exercise professional judgment in deciding whether and when to report a patient to the licensing agency for review of driving privileges.” T Educating Patients on Safe Driving A large international study referenced by the position statement found that almost half of drivers with type 1 diabetes and three-quarters of drivers with type 2 diabetes had never discussed driving guidelines with their physician. “It is important that health care professionals be knowledgeable and take the lead in discussing risk reduction for their patients at risk for hypoglycemia,” and such discussions should occur regularly, the statement stresses. The statement lists some clinical interventions for treating hypoglycemia and specifies measures that health care professionals should recommend to patients at risk for hypoglycemia. These measures include always checking blood glucose before getting behind the wheel and, in the case of patients at risk for disruptive hypoglycemia, always carrying a blood glucose meter and appropriate snacks when driving. A new section in the Association’s “Standards of Medical Care in Diabetes—2012” directly references, and incorporates recommendations from, the “Diabetes and Driving” position statement. ▲ he journals of the American Diabetes Association— Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum—have been optimized for easy use on webenabled mobile devices. The new mobile websites, which launched in early February, are designed to help professional members and others access each publication via smartphones and other devices. Each mobile site’s top-level navigation mimics that of the corresponding traditional site and provides quick access to abstracts, full-text articles, PDFs, tables and figures, and supplementary materials. In addition, a free “ADA Journals” app will soon be available for download in Apple and Android app stores. The app allows users to read, cache, and bookmark full-text journal articles—including the most recent Clinical Practice Recommendations and articles published online ahead of print—and to share this content through social media tools. The app also gives users the option to receive breaking research continued on page 4 2 Professional Section Quarterly http://professional.diabetes.org/CPR_Search http://professional.diabetes.org/CPR_Search

Table of Contents for the Digital Edition of Professional Section Quarterly - Winter 2012

Professional Section Quarterly - Winter 2012