I am always looking for interesting twists and incentives to improve diabetes self care skills, particularly blood glucose monitoring. Indeed, one of my major initiatives to improve blood glucose testing is to link the monitoring to approval of learner's permits. Some states (Maryland) require a physician's signature on an application for learner's permits/driver's license if an adolescent has certain chronic illnesses (such as diabetes) that may affect the ability to drive safely. Hence, starting around age 15, I begin to remind my potential drivers that they need to check blood sugars at least 4 times/day before I am willing to sign the Learner's permit application. They are forewarned and should not be surprised that I will not sign if they do not have at least 3 month of records of the blood checking minimum. I have to provide some incentive to check blood sugars as teens care about the "now" and not about diabetes related complications in the future. The problem may recur after I have signed the forms. How do I continue to motivate my adolescents to continue checking blood sugars more frequently, especially before driving? Teen driving is rife with impulsivity, peer pressure, alcohol/recreational drug use, distraction, and risk taking. Now, let's add the additional liability of hypoglycemia in relation to driving and the risks become logarithmic! Of course, caregivers are ultimately responsible for allowing their adolescents to drive as they can refuse to sign the application as well or not provide keys to the car. However, the healthcare provider is often left to be the "naysayer" in this regard and perform or model limit setting.
I have often joked to my teens that there should be a glucose meter built into the dashboard that requires a certain blood glucose level for the car to start! In this way, not only will the teen be reminded to check blood glucose levels, but also the engine won't ignite if the blood sugar is too low! Theoretically, one could set the meter so that cars won't go if the blood sugar is less than 100 mg/dl (or any other predetermined blood sugar level). And the device could remind you to test at certain intervals (akin to the voice of the Global Positioning Device spokesperson).
It seems that the Ford Motor Company and the Medtronic Corporation may have been eavesdropping (I thought of it first). According to an article published in the Star Tribune/ Business, Ford and Medtronic have collaborated to develop a new device that helps monitor blood sugars while "on the go." The picture as displayed in the article shows the device in the typical GPS location on the dashboard. Apparently, the Ford Company is using the in-car communications technology to assist drivers in monitoring blood glucose while driving. According to article, via application of Bluetooth connectivity, the system connects the Ford "in car infotainment system" (Sync) to a Medtronic continuous glucose monitor! If the driver's blood sugar is too low, an alert sounds or a signal appears on the dashboard screen. According to my source, the Ford-Medtronic prototype is still in the development process and is currently in the research phase. I am hopeful that it will be aggressively marketed once perfected, as I believe there is a place for the device in all people that have the possibility of a hypoglycemic reaction.
There also are other markets for the device such as alcohol breath analyzers, etc., in cars. Perhaps there will be a device with the ability to predict seizures or other medical emergencies that would impair a driver's judgment. The point is to encourage the development of these products if there is a need for them even in a small segment of the population to increase driver safety.
In the meantime, I am continuing to encourage my teens to check blood sugars at least 4 times/day and before driving. I plan to persevere in regard to providing signatures to MVA forms. In this small way, I hope we can help to keep our roads safe and hopefully prevent a disaster secondary to hypoglycemia.
(By the way, be safe and always keep rapid acting carbohydrate on the drivers' person and in the car...in case of hypoglycemia!)
Published On: May 24, 2011