Diabetic Driving StudiesdPart 3: A Comparison of Mean BrakeResponse Time Between Neuropathic Diabetic Drivers With andWithout Foot Pathology

We have previously demonstrated an abnormally delayed mean brake response time and an increased fre-quency of abnormally delayed brake responses in a group of neuropathic diabetic drivers compared with acontrol group of drivers with neither diabetes nor lower extremity neuropathy. The objective of the presentcase-control study was to compare the mean brake response time between neuropathic diabetic drivers withand without specific diabetic foot pathology. The braking performances of the participants were evaluatedusing a computerized driving simulator with specific measurement of the mean brake response time and thefrequency of abnormally delayed brake responses. We analyzed a control group of 20 active drivers with type 2diabetes, lower extremity neuropathy, and no history of diabetic foot pathology and an experimental group of20 active drivers with type 2 diabetes, lower extremity neuropathy, and a history of diabetic foot pathology(ulceration, amputation, and/or Charcot neuroarthropathy) from an urban U.S. podiatric medical clinic.Neuropathic diabetic drivers without a history of specific foot pathology demonstrated an 11.11% slower meanbrake response time (0.7900.223 versus 0.7110.135 second;p<.001), with abnormally delayed reactionsoccurring at a similar frequency (58.13% versus 48.13%;p┬╝.0927). Both groups demonstrated a mean brakeresponse time slower than a suggested threshold of 0.70 second. The results of the present investigationprovide evidence that diabetic patients across a spectrum of lower extremity sensorimotor neuropathy andfoot pathology demonstrate abnormal automobile brake responses and might be at risk of impaired driving function.

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