Type 2 diabetes can undermine driving performance of middle-aged male drivers through its deterioration of perceptual and cognitive functions
Type 2 diabetes can undermine driving performance of middle-aged male drivers through its deterioration of perceptual and cognitive functions
复制标题
2 型糖尿病会导致知觉和认知功能恶化，从而损害中年男性驾驶员的驾驶表现
DOI：
10.1016/j.aap.2019.105334
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发表时间：
2020-01-01
影响因子：
5.9
通讯作者：
Sun, Xianghong
中科院分区：
文献类型：
--
作者：
Ma, Shu;Zhang, Jingyu;Sun, Xianghong
人们普遍认为，糖尿病患者在低血糖期间开车存在风险。但是，在非低血糖期间开车，也可能给部分糖尿病患者带来一定的安全隐患。基于以往糖尿病对早期衰老影响的研究，以及健康信念和驾驶行为的性别差异，我们假设中年男性2型糖尿病驾驶员与对照健康驾驶员相比，可能会在无意识的情况下经历驾驶性能的下降。这种下降是由驾驶相关的知觉和认知功能受损引起的。为了验证这些假设，我们招募了56名年龄在40岁至60岁之间的非职业男性司机（27名2型糖尿病患者和29名健康对照）来执行模拟跟车任务，并在非低血糖期间完成本体感觉，视觉搜索和工作记忆能力的行为测试。他们还报告了他们的低血糖经历和感知驾驶技能。我们发现，患者对自己的驾驶技能有同样的信心，但驾驶性能较差，表现在较大的中心线偏差（t = 2.83，p = 0.006），较长的制动反应时间（t = 3.77，p = 0.001）和较短的最短碰撞时间（t =-3.27，p = 0.002）。这种组间驾驶表现的差异可能完全由本体感觉、视觉搜索能力和工作记忆容量介导，但不是由低血糖经历介导。在中介效应量方面，视觉搜索能力的作用最大，其次是工作记忆和本体感觉，本研究提供了原始的第一手证据，证明了患有2型糖尿病的中年男性驾驶员的驾驶表现恶化，但他们并不知情。我们亦会讨论如何利用这项研究的结果，找出高危人士，并提高他们的安全意识。
It has been widely agreed that it is risky for patients with diabetes to drive during hypoglycemia. However, driving during non-hypoglycemia may also bring certain safety hazards for some patients with diabetes. Based on previous studies on diabetes-related to early aging effect, as well as gender differences in health belief and driving behavior, we have hypothesized that middle-aged male drivers with type 2 diabetes, compared with the control healthy ones, may experience a decline in driving performance without awareness. And the decline is caused by impaired perceptual and cognitive driving-related functions. To verify these hypotheses, we recruited 56 non-professional male drivers aged between 40 and 60 (27 patients with type 2 diabetes and 29 healthy controls) to perform a simulated car-following task and finish behavioral tests of proprioception, visual search, and working memory abilities during non-hypoglycemia. They also reported their hypoglycemia experience and perceived driving skills. We found that the patients had equal confidence in their driving skills but worse driving performance as shown in larger centerline deviation (t = 2.83, p = .006), longer brake reaction time (t = 3.77, p = .001) and shorter minimum time-to-collision (t = -3.27, p = .002). Such between-group differences in driving performance could be fully mediated by proprioception, visual search ability, and working memory capacity but not by hypoglycemia experience. Regarding the effect sizes of the mediation, the visual search ability played the most important role, and then followed the working memory and the proprioception.This initial study provides original and first-hand evidence demonstrating that the middle-aged male drivers with type 2 diabetes have deteriorated driving performance, but they are unaware of it. We will also discuss the possible measures to identify people of the highest risk and improve their safety awareness by using the findings of the current study.