The impact of postbariatric hypoglycaemia on driving performance: A randomized, single‐blind, two‐period, crossover study in a driving simulator

• Published in: Diabetes, obesity & metabolism Vol. 23; no. 9; pp. 2189 - 2193
• Main Authors: Lehmann, Vera, Tripyla, Afroditi, Herzig, David, Meier, Jasmin, Banholzer, Nicolas, Maritsch, Martin, Zehetner, Jörg, Giachino, Daniel, Nett, Philipp, Feuerriegel, Stefan, Wortmann, Felix, Bally, Lia
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-09-2021; Wiley Subscription Services, Inc
• Subjects: bariatric surgery; Bayesian analysis; Blood glucose; Body mass index; Diabetes; Driving ability; Gastrointestinal surgery; Glucose; hypoglycaemia; Hypoglycemia
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.14456

Postbariatric hypoglycaemia (PBH) is an increasingly recognized complication of bariatric surgery, but its effect on daily functioning remains unclear. In this randomized, single‐blind, crossover trial we assessed driving performance in patients with PBH. Ten active drivers with PBH (eight females, age 38.2 ± 14.7 years, body mass index 27.2 ± 4.6 kg/m2) received 75 g glucose to induce PBH in the late postprandial period and aspartame to leave glycaemia unchanged, on two different occasions. A simulator was driven during 10 minutes before (D0) and 20 (D1), 80 (D2), 125 (D3) and 140 minutes (D4) after the glucose/aspartame ingestion, reflecting the expected blood glucose (BG) increase (D1), decrease (D2) and hypoglycaemia (D3, D4). Seven driving features indicating impaired driving were integrated in a Bayesian hierarchical regression model to assess the difference in driving performance after glucose/aspartame ingestion. Mean ± standard deviation peak and nadir BG after glucose were 182 ± 24 and 47 ± 14 mg/dL, while BG was stable after aspartame (85 ± 4 mg/dL). Despite the lack of a difference in symptom perception, driving performance was significantly impaired after glucose versus aspartame during D4 (posterior probability 98.2%). Our findings suggest that PBH negatively affects driving performance.