Published on 10 May 2019

Study reports that more awareness is needed about impact of diabetes-related neuropathy on drivers.

Researchers are calling for more awareness about preparing to drive for people with diabetes-related nerve damage.

A recently published report in Diabetic Medicine revealed that drivers with diabetes-related nerve damage could have less precise control of their vehicles.

The study was carried out by researchers at Manchester Metropolitan University who looked at whether driving behaviour was affected by diabetes-related peripheral neuropathy and the associated loss of sensation and awareness of where your limbs are in relation to each other.

The results of the study revealed that there were important differences in how people with diabetes-related nerve damage used the accelerator pedal compared to both people without diabetes and people with diabetes that do not have diabetes-related neuropathy.

People with diabetes-related nerve damage were found to have less precise control of the pedal compared to those without the condition.

While existing driving considerations for people with diabetes have focussed on the importance of good eyesight or preventing a hypoglycaemic episode (low blood glucose) behind the wheel, until this study there has been limited information about the impact of peripheral neuropathy on car pedal control.

Study authors said the less well-known consideration of the risk of driving with diabetes-related nerve damage suggesting the need for increased awareness and training from health practitioners. 

However, the research also showed that people with diabetes-related neuropathy could learn to counteract the impact of the condition.

A man driving a car.

Lead academic Dilwyn Marple-Horvat, Professor of Motor Neuroscience at Manchester Metropolitan, said: “Importantly, we found that people got better from one test drive to the next, which suggests people with diabetes-related neuropathy improve when driving the same route repeatedly, as in your daily commute.

“Perhaps they could improve more if given feedback and instruction, and we have some ideas for technological solutions and training programmes to do this.

“We found those with diabetic neuropathy had less subtle control of the accelerator, using its mid-range much less than other drivers — they tended to either only lightly touch the pedal, or really put their foot down, resulting in strong acceleration so that  after just a few seconds the car would be moving much more quickly.

“We found this sometimes led to a driver needing to make quicker and bigger movements of the steering wheel to stay in lane, which is not ideal.”

Professor Marple-Horvat added that on average people with diabetes-related neuropathy drove more slowly than the other groups tested, which would reduce the dangers of driving generally.

He suggested there may be scope for doctors and nurses to issue specific neuropathy motoring advice during consultations as they do for eyesight and blood sugar monitoring.

In addition, researchers noted that the onset of diabetes-related neuropathy can be very gradual.

An estimated 9% of the UK adult population have diabetes and it is estimated that around half of these will experience symptoms of diabetes-related peripheral neuropathy, that could add up to a potential 1.5 million motorists.

People may not realise anything is wrong until they experience a loss of pain sensation in their foot or develop an ulcer, two of the common triggers for a diagnosis.

The slow-onset of the condition means the development of associated driving difficulties may be just as gradual, and may go unnoticed by a driver, who could be using their vehicle unaware of the changes and possible dangers.

The Manchester Metropolitan team hopes the study’s findings will bring greater attention to the implications for driving of diabetic peripheral nerve damage and how to manage or reverse these changes in driving. 

Many of the study participants were recruited through Research for the Future, a National Institute for Health Research initiative, which helps find volunteers for research across Greater Manchester, hosted by Salford Royal Hospital, part of the Northern Care Alliance NHS Group.

Katherine Grady, Service Manager at Research for the Future said: “Lots of people living with diabetes were eager to participate in this study, which suggests this previously unexplored area of research is important to them.

“Symptoms of diabetes-related neuropathy typically develop over many months or years and can go unnoticed. This study highlights the importance of people with diabetes attending their annual foot check to detect potential problems early and receive appropriate advice from their healthcare team.”

Read the report in Diabetic Medicine
Read the DRWF leaflet How can diabetes affect my feet? here
Find out more about driving with diabetes regulations on the DVLA website

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