Diabetic peripheral neuropathy adversely affects driving performance of patients

Diabetic peripheral neuropathy adversely affects driving performance, however, this can be improved with practice.

UK: A recent study published in the journal Diabetic Medicine has suggested motorists with diabetic peripheral neuropathy (DPN) to drive at a slower speed as they are at increased risk for losing control of the vehicle. This is due to impaired muscle function, ankle proprioception, and accelerator pedal control people with DPN, affecting their overall driving performance.

Monica Perazzolo, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK, and colleagues conducted the study to investigate whether the sensory‐motor impairment attributable to DPN would affect control of the accelerator pedal during a driving simulator task.

"Control of the accelerator pedal and overall driving performance are affected by DPN, but this research opens up opportunities to devise technological solutions and training programmes to help people with DPN drive more safely," write the authors.

“In addition to locomotor tasks, driving is another common daily activity where the integration of motor and sensory function is important for successful performance," they further added. “Concerning this last issue, a few recent studies have demonstrated that people with DPN had slower mean brake response times and have an increased frequency of abnormally delayed braking reactions compared with both people with diabetes but no [diabetic peripheral neuropathy] and healthy individuals, when driving on a simulator.”

In a cohort of 32 licensed drivers in the United Kingdom, with 11 having diabetic peripheral neuropathy (mean age, 67 years; 18.2% women), 10 having diabetes only (mean age, 62 years; 10% women) and 11 having no diabetes (mean age 60 years; 18.2% women), the researchers assessed ankle and foot strength as well as driving performance. Ankle and foot strength was assessed by testing the planta flexor muscles on a dynamometer footplate that acted similarly to a brake pedal. Driving performance was evaluated during two repeated 3.1-mile simulated driving tests.

On the basis of the study, they found that:

• Participants with diabetic peripheral neuropathy had weaker maximal plantar flexor muscle strength and lower ankle proprioception function, which contributes to more driver errors, compared with those without diabetes.


• Measures for the group with diabetes but no neuropathy were similar to those for the group without diabetes.


• The neuropathy group also took longer to build up strength in their foot than those without diabetes, and slower speeds were also recorded for those with diabetes compared with those without the condition.


• During the first driving test, those with diabetic peripheral neuropathy averaged a speed of 16.53 miles per hour compared to speeds of 20.41 miles per hour by those with diabetes alone and 22.08 miles per hour by those without diabetes.


• Speeds increased for all groups in the second test, but those with DPN still had the slowest speed (18.55 miles per hour) compared with those with diabetes (21.56 miles per hour) and those without diabetes (24.06 miles per hour).


• Participants with DPN spent 59.07 seconds in “loss-of-control events” during the first test, which compared with 13.02 seconds and 5.86 seconds in those with diabetes and without diabetes, respectively.


• Time in “loss-of-control events” was cut to 13.83 seconds during the second drive for drivers with diabetic peripheral neuropathy, which was significantly lower than those without diabetes but not those with diabetes.

"Whilst people with DPN might represent an increased risk with regard to driving safely, our findings indicate that drivers with DPN potentially retain a residual ability to improve, but further research will determine whether this potential for improvement can be realized through a specific, standardized and systematic training programme," concluded the authors.

For detailed study follow the link: https://doi.org/10.1111/dme.13957