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背景糖尿病并发症可威胁驾驶员安全驾驶机动车的能力,而血糖正常是否可预测糖尿病成人驾驶风险在正常范围了解甚少。我们对糖化血红蛋白(HbA1c)与机动车事故风险关联做了人群案例对照分析。方法和发现于2005-01-01—2007-01-01我们对持有驾驶执照被诊断为糖尿病的驾驶员,记录了他们的HbA1c。重视了交通事故风险潜在的混合因素,包括血糖监测、并发症和治疗。发生1起交通事故总数为57例病人,738例未发生事故。与对照组相比,发生事故者平均HbA1c要低(7.4%versus7.9%,非配对t检验,P=0.019)。HbA1c每降低1%发生交通事故的风险性就增加26%[优势比=1.26,95%CI为(1.03,1.54)]。这种趋势在HbA1c范围值明显展露,在修正了测量出的混杂因素后这种趋势持续[优势比=1.25,95%CI为(1.02,1.55)]。对事故,有2个重要风险因素,有严重低血糖史需要提供外界帮助[优势比=4.07,95%CI为(2.35,7.04)],有糖尿病诊断年龄较长者[优势比/10年=1.29,95%CI为(1.07,1.57)]。结论所选的人群,较为严格控制血糖,测量了HbA1c,与机动车事故风险性增加关联。
Background Diabetic complications can threaten the driver’s ability to safely drive a motor vehicle, and whether or not the normal blood glucose can predict the risk of driving adults with diabetes is poorly understood in the normal range. We conducted a population-based case-control analysis of the association between HbA1c and the risk of motor vehicle accidents. Methods and Discovessions 2005-01-01-2007-01-01 We recorded their HbA1c for drivers who had a driver’s license who was diagnosed with diabetes. Attaches importance to potential mixed factors in traffic accident risk, including blood glucose monitoring, complications and therapies. A total of 57 traffic accidents occurred in one case and 738 cases did not occur. The average HbA1c was lower in those who had an accident (7.4% versus 7.9%, unpaired t-test, P = 0.019) compared with controls. Every 1% reduction in HbA1c increased the risk of traffic accidents by 26% [odds ratio = 1.26, 95% CI (1.03, 1.54)]. This trend is evident at the HbA1c range, which persisted after the measured confounders were corrected [odds ratio = 1.25, 95% CI (1.02, 1.55)]. There were 2 important risk factors for the accident and a history of severe hypoglycemia was needed to provide outside help (odds ratio = 4.07; 95% CI, 2.35, 7.04); older diabetic patients with diagnosis of diabetes [odds ratio / 10 years = 1.29, 95% CI (1.07, 1.57)]. Conclusions The selected population, more strictly controlled blood glucose, measured HbA1c, associated with an increased risk of motor vehicle accidents.