Download PDF
Diabetologie und Stoffwechsel 2018; 13(01): 54-97
DOI: 10.1055/s-0043-124953
DDG Praxisempfehlung
© Georg Thieme Verlag KG Stuttgart · New York

S2e-Leitlinie Diabetes und Straßenverkehr

1. Auflage 2017– AWMF-Register-Nr. 057-026
Oliver Ebert
,
Barbara Bohn
,
Bernd Bertram
,
Barbara Buchberger
,
Hermann Finck†   *
,
Jürgen Hoß
,
Peter Hübner
,
Laura Krabbe
,
Bernhard Kulzer
,
Eva Küstner
,
Bernhard Lachenmayr
,
Klaus-Dieter Lemmen
,
Friedhelm Petry
,
Kurt Rinnert
,
Markus Salomon
,
Wolfgang Schütt
,
Reinhard W Holl
Herausgeber der Leitlinie Diabetes und Straßenverkehr Deutsche Diabetes Gesellschaft (DDG)
Further Information

Publication History

Publication Date:
27 February 2018 (online)

Also available at
    Permissions and Reprints

Widmung

Die Autoren widmen die Leitlinie Herrn Dr. med. Hermann Finck. Dr. Finck hat das Thema „Diabetes und Führerschein“ über Jahrzehnte als Vorsitzender des Ausschusses Soziales der DDG bearbeitet und sich für die Belange von Menschen mit Diabetes in Deutschland eingesetzt. Dr. Finck hat die Autorengruppe inspiriert, die Entwicklung dieser Leitlinie initiiert und die ersten Schritte begleitet. Leider war es ihm nicht vergönnt, die Fertigstellung zu erleben.

Hinweis

Der Anhang wird hier zur Verfügung gestellt: https://doi.org/10.1055/s-0043-124953

Darin finden Sie die folgenden Informationen und Dokumente:

  • Anhang A: Erklärung über Interessenkonflikte

  • Anhang B: Diabetes and Driving

  • Anhang C: Suchstrategie und Dokumentation der Literaturrecherche

  • Anhang D: Evidenztabellen

  • Anhang E: Leitlinien/Positionspapiere zum Thema „Diabetes und Fahrsicherheit“ aus anderen Ländern

  • Anhang F: Fahrerlaubnis-Verordnung – Anlage 4

  • Anhang G: Fahrerlaubnis-Verordnung – Anlage 5

  • Anhang H: Begutachtungsleitlinien zur Kraftfahreignung der Bundesanstalt für Straßenwesen (BASt)

  • Anhang I: Definition und Häufigkeit von Hypoglykämien

  • Anhang J: Hypoglykämierisiko bei unterschiedlichen Medikamenten

  • Anhang K: Übersicht der Herz- und Gefäßkrankheiten und deren Auswirkungen auf die Fahreignung gemäß BASt (August 17)

  • Anhang L: Inhalte/Themen in der Diabetesschulung in aktuellen Leitlinien

  • Anhang M: Empfehlungen für Kraftfahrer mit Diabetes unter Behandlung mit Sulfonylharnstoffen und/oder Insulin

* † 14. Juli 2016


Ergänzendes Material/Supplementary Material

 

  • Literatur

  • 1 OCEBM Levels of Evidence Working Group. The Oxford Levels of Evidence 2. Oxford Centre for Evidence-Based Medicine. 2014 http://www.cebm.net/index.aspx?o=5653 . Accessed 24 Nov 2015
    PubMedGoogle Scholar
  • 2 Wasem J, Staudt S, Matusiewicz D. editor Medizinmanagement: Grundlagen und Praxis. Medizinisch Wissenschaftliche Verlagsgesellschaft; 2013 1st ed.
    Google Scholar
  • 3 Kraftfahrt-Bundesamt. Kraftfahrer. Fahrerlaubnisse. 2015 http://www.kba.de/DE/Statistik/Kraftfahrer/Fahrerlaubnisse/fahrerlaubnisse_node.html . Accessed 28 Oct 2015
    PubMedGoogle Scholar
  • 4 Kalinowska D, Kloas J, Kuhfeld H. Deutsches Institut für Wirtschaftsforschung (DWi).. Fahrerlaubnisbesitz in Deutschland. Berichte der Bundesanstalt für Straßenwesen. Bremerhafen: 2007
    PubMedGoogle Scholar
  • 5 Bundesministerium der Justiz und für Verbraucherschutz. Verordnung über die Zulassung von Personen zum Straßenverkehr (Fahrerlaubnis-Verordnung – FeV). 2014
    PubMedGoogle Scholar
  • 6 Berghaus G, Brenner-Hartmann J. Fahrsicherheit und Fahreignung – Determinanten der Verkehrssicherheit. In: Madea B, Mußhoff F, Berghaus G. editor Verkehrsmedizin. Fahreignung, Fahrsicherheit, Unfallrekonstruktion. Köln: Deutscher Ärzteverlag GmbH; 2012: 131-144
    Google Scholar
  • 7 Finck H. Verkehrsmedizinische Aspekte beim Diabetes mellitus. In: Häring HU, Gallwitz B, Müller-Wieland D. et al. editor Diabetologie in Klinik und Praxis. 6th ed. Stuttgart, New York: Georg Thieme Verlag; 2013: 640-645
    Google Scholar
  • 8 Inkster B, Frier BM. Diabetes and driving. Diabetes Obes Metab 2013; 15: 775-783
    PubMedGoogle Scholar
  • 9 IKK-Bundesverband. Diabetiker haben nicht mehr Unfälle als Nicht-Diabetiker. 2007 http://www.diabetes-deutschland.de/archiv/5180.htm . Accessed 27 Oct 2015
    PubMedGoogle Scholar
  • 10 Abu Dabrh AM, Firwana B, Cowl CT. et al. Health assessment of commercial drivers: a meta-narrative systematic review. BMJ Open 2014; 4: e003434
    CrossrefPubMedGoogle Scholar
  • 11 Cox DJ, Kovatchev BP, Anderson SM. et al. Type 1 diabetic drivers with and without a history of recurrent hypoglycemia-related driving mishaps: physiological and performance differences during euglycemia and the induction of hypoglycemia. Diabetes Care 2010; 33: 2430-2435
    CrossrefPubMedGoogle Scholar
  • 12 Bundesanstalt für Straßenwesen (BASt). Begutachtungsleitlinien zur Kraftfahreignung. Bremen: 2017
    PubMedGoogle Scholar
  • 13 Statistisches Bundesamt. Unfälle (polizeilich erfasste): Deutschland; Jahre, Unfallkategorie, Ortslage (Code 46241). 2017 https://www-genesis.destatis.de/genesis/online/data;jsessionid=D4DA18F69FA40064A260B343F912EDB8.tomcat_GO_1_2?operation=abrufTab.Bearbeiten&levelindex=2&levelid=1439464398034&auswahloperation=abrufTab.AuspraegungAuswaehlen&auswahlverzeichnis=ordnungsstruktur&auswahlziel=werteabruf&selectionname=46241-0001&auswahltext=&werteabruf=Werteabruf . Accessed 14 Jun 2017
    PubMedGoogle Scholar
  • 14 Statistisches Bundesamt. Verkehr: Verkehrsunfälle. Wiesbaden: 2016
    PubMedGoogle Scholar
  • 15 Hostiuc S, Negoi I, Hostiuc M. Diabetes and collision risk. A meta-analysis and meta-regression. Int J Clin Pract 2016; 70: 554-568
    CrossrefPubMedGoogle Scholar
  • 16 Cox DJ, Singh H, Lorber D. Diabetes and driving safety: science, ethics, legality and practice. Am J Med Sci 2013; 345: 263-265
    CrossrefPubMedGoogle Scholar
  • 17 Jerome L, Habinski L, Segal A. Attention-deficit/hyperactivity disorder (ADHD) and driving risk: a review of the literature and a methodological critique. Curr Psychiatry Rep 2006; 8: 416-426
    CrossrefPubMedGoogle Scholar
  • 18 Tregear S, Reston J, Schoelles K. et al. Obstructive sleep apnea and risk of motor vehicle crash: systematic review and meta-analysis. J Clin Sleep Med 2009; 5: 573-581
    CrossrefPubMedGoogle Scholar
  • 19 Südwest Presse. Unterzuckerung Ursache für Vukcevic-Unfall. 2012 http://www.swp.de/ulm/sport/fussball/ueberregional/Unterzuckerung-Autounfall-Auswertung-Unterlage-Mannheim-Heilbronn-Nuernberg-Bammental-Heidelberg;art4314,1674438 . Accessed 27 Oct 2015
    PubMedGoogle Scholar
  • 20 kma medien. Managementwissen für die Gesundheitswirtschaft. Falsche Darstellung von Diabetes Typ 1. Tatort verfehlt medizinische Realität. Bericht vom 07.05.2013. 2013 http://www.kma-online.de/nachrichten/medizin/falsche-darstellung-von-diabetes-typ-1-tatort-verfehlt-medizinische-realitaet_id_30926_view.html . Accessed 28 Oct 2015
    PubMedGoogle Scholar
  • 21 Edwards B. Why does Hollywood keep getting diabetes so wrong?. http://usvsth3m.com/post/99395519083/why-does-hollywood-keep-getting-diabetes-so-wrong . Accessed 27 Oct 2015
    Google Scholar
  • 22 Kagan A, Hashemi G, Korner-Bitensky N. Diabetes Fitness to Drive: A Systematic Review of the Evidence with a Focus on Older Drivers. Canadian Journal of Diabetes 2010; 34: 233-242
    CrossrefGoogle Scholar
  • 23 ECRI. Plymouth Meeting. ECRI. Diabetes and Commercial Motor Vehicle Safety (Federal Motor Carrier Safety Administration). Pennsylvania: 2011
    PubMedGoogle Scholar
  • 24 Lonnen KF, Powell RJ, Taylor D. et al. Road traffic accidents and diabetes: insulin use does not determine risk. Diabet Med 2008; 25: 578-584
    CrossrefPubMedGoogle Scholar
  • 25 Kennedy RL, Henry J, Chapman AJ. et al. Accidents in patients with insulin-treated diabetes: increased risk of low-impact falls but not motor vehicle crashes--a prospective register-based study. J Trauma 2002; 52: 660-666
    CrossrefPubMedGoogle Scholar
  • 26 Cox DJ, Ford D, Gonder-Frederick L. et al. Driving mishaps among individuals with type 1 diabetes: a prospective study. Diabetes Care 2009; 32: 2177-2180
    CrossrefPubMedGoogle Scholar
  • 27 Pedersen-Bjergaard U, Færch L, Allingbjerg ML. et al. The influence of new European Union driver’s license legislation on reporting of severe hypoglycemia by patients with type 1 diabetes. Diabetes Care 2015; 38: 29-33
    PubMedGoogle Scholar
  • 28 Brož J, Brabec M, Žďárská DJ. et al. Fear of driving license withdrawal in patients with insulin-treated diabetes mellitus negatively influences their decision to report severe hypoglycemic events to physicians. Patient Prefer Adherence 2015; 9: 1367-1370
    CrossrefPubMedGoogle Scholar
  • 29 Dømgaard M, Bagger M, Rhee NA. et al. Individual and societal consequences of hypoglycemia: A cross-sectional survey. Postgrad Med 2015; 127: 438-445
    Google Scholar
  • 30 American Diabetes Association. Standards of Medical Care in Diabetes--2013. Diabetes Care 2012; 36 (Suppl. 01) S11-S66
    Google Scholar
  • 31 Akram K, Pedersen-Bjergaard U, Borch-Johnsen K. et al. Frequency and risk factors of severe hypoglycemia in insulin-treated type 2 diabetes: a literature survey. J Diabetes Complications 2006; 20: 402-408
    CrossrefPubMedGoogle Scholar
  • 32 Hermanns N, Kulzer B, Maier B. et al. Risikoindikatoren für das Auftreten schwerer Hypoglykämien bei Patientenmit Typ-1-Diabetes mellitus. Diabetes & Stoffwechsel 2002; 11: 145-149
    Google Scholar
  • 33 Pedersen-Bjergaard U, Pramming S, Heller SR. et al. Severe hypoglycaemia in 1076 adult patients with type 1 diabetes: influence of risk markers and selection. Diabetes Metab Res Rev 2004; 20: 479-486
    CrossrefPubMedGoogle Scholar
  • 34 Cox DJ, Gonder-Frederick L, Clarke W. Driving decrements in type I diabetes during moderate hypoglycemia. Diabetes 1993; 42: 239-243
    CrossrefPubMedGoogle Scholar
  • 35 Cox DJ, Gonder-Frederick LA, Kovatchev BP. et al. Progressive hypoglycemia’s impact on driving simulation performance. Occurrence, awareness and correction. Diabetes Care 2000; 23: 163-170
    CrossrefPubMedGoogle Scholar
  • 36 Cox DJ, Gonder-Frederick LA, Kovatchev BP. et al. Self-treatment of hypoglycemia while driving. Diabetes Res Clin Pract 2001; 54: 17-26
    CrossrefPubMedGoogle Scholar
  • 37 Stork ADM, van Haeften TW, Veneman TF. The decision not to drive during hypoglycemia in patients with type 1 and type 2 diabetes according to hypoglycemia awareness. Diabetes Care 2007; 30: 2822-2826
    CrossrefPubMedGoogle Scholar
  • 38 Weinger K, Kinsley BT, Levy CJ. et al. The perception of safe driving ability during hypoglycemia in patients with type 1 diabetes mellitus. Am J Med 1999; 107: 246-253
    CrossrefPubMedGoogle Scholar
  • 39 Brietzke SA. Oral antihyperglycemic treatment options for type 2 diabetes mellitus. Med Clin North Am 2015; 99: 87-106
    CrossrefPubMedGoogle Scholar
  • 40 Inkster B, Zammitt NN, Frier BM. Drug-induced hypoglycaemia in type 2 diabetes. Expert Opin Drug Saf 2012; 11: 597-614
    CrossrefPubMedGoogle Scholar
  • 41 Matthaei S, Bierwirth R, Fritsche A. et al. Medikamentöse antihyperglykämische Therapie des Diabetes mellitus Typ 2. Diabetologie und Stoffwechsel 2009; 4: 32-64
    Article in Thieme ConnectGoogle Scholar
  • 42 Siegel E. Medikamentose und Insulintherapie bei Diabetes mellitus Typ 2. Update. Internist (Berl) 2015; 56: 493-502
    CrossrefPubMedGoogle Scholar
  • 43 International Hypoglycaemia Study Group. Minimizing hypoglycemia in diabetes. Diabetes Care 2015; 38: 1583-1591
    CrossrefPubMedGoogle Scholar
  • 44 Cox DJ, Gonder-Frederick L, Ritterband L. et al. Blood Glucose Awareness Training: What Is It, Where Is It, and Where Is It Going?. Diabetes Spectrum 2006; 19: 43-49
    CrossrefGoogle Scholar
  • 45 Schächinger H, Cox D, Linder L. et al. Cognitive and psychomotor function in hypoglycemia: response error patterns and retest reliability. Pharmacol Biochem Behav 2003; 75: 915-920
    CrossrefPubMedGoogle Scholar
  • 46 Hermanns N, Kulzer B, Kubiak T. et al. The effect of an education programme (HyPOS) to treat hypoglycaemia problems in patients with type 1 diabetes. Diabetes Metab Res Rev 2007; 23: 528-538
    CrossrefPubMedGoogle Scholar
  • 47 Hermanns N, Kulzer B, Krichbaum M. et al. Long-term effect of an education program (HyPOS) on the incidence of severe hypoglycemia in patients with type 1 diabetes. Diabetes Care 2010; 33: e36
    CrossrefPubMedGoogle Scholar
  • 48 Yeoh E, Choudhary P, Nwokolo M. et al. Interventions that restore awareness of hypoglycemia in adults with type 1 diabetes: A systematic review and meta-analysis. Diabetes Care 2015; 38: 1592-1609
    CrossrefPubMedGoogle Scholar
  • 49 Campbell LK, Gonder-Frederick LA, Broshek DK. et al. Neurocognitive differences between drivers with type 1 diabetes with and without a recent history of recurrent driving mishaps. Int J Diabetes Mellit 2010; 2: 73-77
    PubMedGoogle Scholar
  • 50 Cox DJ, Kovatchev BP, Gonder-Frederick LA. et al. Physiological and performance differences between drivers with type 1 diabetes with and without a recent history of driving mishaps: An exploratory study. Can J Diabetes 2003; 27: 23-28
    Google Scholar
  • 51 Cox DJ, Penberthy JK, Zrebiec J. et al. Diabetes and driving mishaps: frequency and correlations from a multinational survey. Diabetes Care 2003; 26: 2329-2334
    CrossrefPubMedGoogle Scholar
  • 52 Graveling AJ, Warren RE, Frier BM. Hypoglycaemia and driving in people with insulin-treated diabetes: adherence to recommendations for avoidance. Diabet Med 2004; 21: 1014-1019
    CrossrefPubMedGoogle Scholar
  • 53 Watson WA, Currie T, Lemon JS. et al. Driving and insulin-treated diabetes: Who knows the rules and recommendations?. Pract Diab Int 2007; 24: 201-206
    CrossrefGoogle Scholar
  • 54 Moniz C, Ferreira R, Serra F. et al. Driving with diabetes: What is the Portuguese doctors’ and patients’ knowledge?. Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo 2015; 10: 14-17
    CrossrefGoogle Scholar
  • 55 Fanelli CG, Epifano L, Rambotti AM. et al. Meticulous prevention of hypoglycemia normalizes the glycemic thresholds and magnitude of most of neuroendocrine responses to, symptoms of, and cognitive function during hypoglycemia in intensively treated patients with short-term IDDM. Diabetes 1993; 42: 1683-1689
    CrossrefPubMedGoogle Scholar
  • 56 Leelarathna L, Little SA, Walkinshaw E. et al. Restoration of self-awareness of hypoglycemia in adults with long-standing type 1 diabetes: hyperinsulinemic-hypoglycemic clamp substudy results from the HypoCOMPaSS trial. Diabetes Care 2013; 36: 4063-4070
    CrossrefPubMedGoogle Scholar
  • 57 Fritsche A, Stefan N, Haring H. et al. Avoidance of hypoglycemia restores hypoglycemia awareness by increasing beta-adrenergic sensitivity in type 1 diabetes. Ann Intern Med 2001; 134: 729-736
    CrossrefPubMedGoogle Scholar
  • 58 Böhm B, Dreyer M, Fritsche A. et al. Therapie des Typ-1-Diabetes. Diabetologie und Stoffwechsel 2015; 10: S129-S139
    Article in Thieme ConnectGoogle Scholar
  • 59 Allen KV, Pickering MJ, Zammitt NN. et al. Effects of acute hypoglycemia on working memory and language processing in adults with and without type 1 diabetes. Diabetes Care 2015; 38: 1108-1115
    CrossrefPubMedGoogle Scholar
  • 60 Draelos MT, Jacobson AM, Weinger K. et al. Cognitive function in patients with insulin-dependent diabetes mellitus during hyperglycemia and hypoglycemia. Am J Med 1995; 98: 135-144
    CrossrefPubMedGoogle Scholar
  • 61 Geddes J, Deary IJ, Frier BM. Effects of acute insulin-induced hypoglycaemia on psychomotor function: people with type 1 diabetes are less affected than non-diabetic adults. Diabetologia 2008; 51: 1814-1821
    CrossrefPubMedGoogle Scholar
  • 62 Holmes CS, Hayford JT, Gonzalez JL. et al. A survey of cognitive functioning at difference glucose levels in diabetic persons. Diabetes Care 1983; 6: 180-185
    CrossrefPubMedGoogle Scholar
  • 63 McAulay V, Deary IJ, Ferguson SC. et al. Acute hypoglycemia in humans causes attentional dysfunction while nonverbal intelligence is preserved. Diabetes Care 2001; 24: 1745-1750
    CrossrefPubMedGoogle Scholar
  • 64 McAulay V, Deary IJ, Sommerfield AJ. et al. Attentional functioning is impaired during acute hypoglycaemia in people with type 1 diabetes. Diabet Med 2006; 23: 26-31
    CrossrefPubMedGoogle Scholar
  • 65 Sommerfield AJ, Deary IJ, McAulay V. et al. Short-term, delayed, and working memory are impaired during hypoglycemia in individuals with type 1 diabetes. Diabetes Care 2003; 26: 390-396
    CrossrefPubMedGoogle Scholar
  • 66 Warren RE, Frier BM. Hypoglycaemia and cognitive function. Diabetes Obes Metab 2005; 7: 493-503
    CrossrefPubMedGoogle Scholar
  • 67 Warren RE, Zammitt NN, Deary IJ. et al. The effects of acute hypoglycaemia on memory acquisition and recall and prospective memory in type 1 diabetes. Diabetologia 2007; 50: 178-185
    PubMedGoogle Scholar
  • 68 Cryer PE. Mechanisms of hypoglycemia-associated autonomic failure and its component syndromes in diabetes. Diabetes 2005; 54: 3592-3601
    CrossrefPubMedGoogle Scholar
  • 69 Segel SA, Paramore DS, Cryer PE. Hypoglycemia-associated autonomic failure in advanced type 2 diabetes. Diabetes 2002; 51: 724-733
    CrossrefPubMedGoogle Scholar
  • 70 Amiel SA, Dixon T, Mann R. et al. Hypoglycaemia in type 2 diabetes. Diabet Med 2008; 25: 245-254
    CrossrefPubMedGoogle Scholar
  • 71 Awoniyi O, Rehman R, Dagogo-Jack S. Hypoglycemia in patients with type 1 diabetes: epidemiology, pathogenesis, and prevention. Curr Diab Rep 2013; 13: 669-678
    CrossrefPubMedGoogle Scholar
  • 72 Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie Therapie des Typ-2-Diabetes – Langfassung. 2013 zuletzt geändert: April 2014 1. Auflage. Version 3.
    PubMedGoogle Scholar
  • 73 Ben Salem C, Fathallah N, Hmouda H. et al. Drug-induced hypoglycaemia: an update. Drug Saf 2011; 34: 21-45
    CrossrefPubMedGoogle Scholar
  • 74 Vos RC, van Avendonk MJ, Jansen H. et al. Insulin monotherapy compared with the addition of oral glucose-lowering agents to insulin for people with type 2 diabetes already on insulin therapy and inadequate glycaemic control. Cochrane Database Syst Rev 2016; 9: CD006992
    PubMedGoogle Scholar
  • 75 Harsch IA, Stocker S, Radespiel-Tröger M. et al. Traffic hypoglycaemias and accidents in patients with diabetes mellitus treated with different antidiabetic regimens. J Intern Med 2002; 252: 352-360
    CrossrefPubMedGoogle Scholar
  • 76 McGwin Jr G, Sims RV, Pulley L. et al. Diabetes and automobile crashes in the elderly. A population-based case-control study. Diabetes Care 1999; 22: 220-227
    CrossrefPubMedGoogle Scholar
  • 77 Skurtveit S, Strøm H, Skrivarhaug T. et al. Road traffic accident risk in patients with diabetes mellitus receiving blood glucose-lowering drugs. Prospective follow-up study. Diabet Med 2009; 26: 404-408
    CrossrefPubMedGoogle Scholar
  • 78 Diabetes Control and Complications Trial (DCCT) Research Group. Hypoglycemia in the Diabetes Control and Complications Trial. The Diabetes Control and Complications Trial Research Group. Diabetes 1997; 46: 271-286
    CrossrefPubMedGoogle Scholar
  • 79 Bott S, Bott U, Berger M. et al. Intensified insulin therapy and the risk of severe hypoglycaemia. Diabetologia 1997; 40: 926-932
    CrossrefPubMedGoogle Scholar
  • 80 Gold AE, MacLeod KM, Frier BM. Frequency of severe hypoglycemia in patients with type I diabetes with impaired awareness of hypoglycemia. Diabetes Care 1994; 17: 697-703
    CrossrefPubMedGoogle Scholar
  • 81 Schütt M, Fach EM, Seufert J. et al. Multiple complications and frequent severe hypoglycaemia in “elderly” and “old” patients with Type 1 diabetes. Diabet Med 2012; 29: 9
    Google Scholar
  • 82 Akram K, Pedersen-Bjergaard U, Carstensen B. et al. Frequency and risk factors of severe hypoglycaemia in insulin-treated type 2 diabetes: a cross-sectional survey. Diabet Med 2006; 23: 750-756
    CrossrefPubMedGoogle Scholar
  • 83 Henderson JN, Allen KV, Deary IJ. et al. Hypoglycaemia in insulin-treated Type 2 diabetes: frequency, symptoms and impaired awareness. Diabet Med 2003; 20: 1016-1021
    CrossrefPubMedGoogle Scholar
  • 84 Schloot NC, Haupt A, Schütt M. et al. Risk of severe hypoglycemia in sulfonylurea-treated patients from diabetes centers in Germany/Austria: How big is the problem? Which patients are at risk?. Diabetes Metab Res Rev 2016; 32: 316-324
    CrossrefPubMedGoogle Scholar
  • 85 Davis WA, Brown SGA, Jacobs IG. et al. Angiotensin-converting enzyme insertion/deletion polymorphism and severe hypoglycemia complicating type 2 diabetes: the Fremantle Diabetes Study. J Clin Endocrinol Metab 2011; 96: 700
    Google Scholar
  • 86 Færch L, Pedersen-Bjergaard U, Thorsteinsson B. High serum ACE activity predicts severe hypoglycaemia over time in patients with type 1 diabetes. Scand J Clin Lab Invest 2011; 71: 620-624
    CrossrefPubMedGoogle Scholar
  • 87 Pedersen-Bjergaard U, Nielsen SL, Akram K. et al. Angiotensin-converting enzyme and angiotensin II receptor subtype 2 genotypes in type 1 diabetes and severe hypoglycaemia requiring emergency treatment: a case cohort study. Pharmacogenet Genomics 2009; 19: 864-868
    CrossrefPubMedGoogle Scholar
  • 88 Songer TJ, Dorsey RR. High risk characteristics for motor vehicle crashes in persons with diabetes by age. Annu Proc Assoc Adv Automot Med 2006; 50: 335-351
    PubMedGoogle Scholar
  • 89 Redelmeier DA, Kenshole AB, Ray JG. Motor vehicle crashes in diabetic patients with tight glycemic control: a population-based case control analysis. PLoS Med 2009; 6: e1000192
    CrossrefPubMedGoogle Scholar
  • 90 Signorovitch JE, Macaulay D, Diener M. et al. Hypoglycaemia and accident risk in people with type 2 diabetes mellitus treated with non-insulin antidiabetes drugs. Diabetes Obes Metab 2013; 15: 335-341
    CrossrefPubMedGoogle Scholar
  • 91 Cheyne EH, Sherwin RS, Lunt MJ. et al. Influence of alcohol on cognitive performance during mild hypoglycaemia; implications for Type 1 diabetes. Diabet Med 2004; 21: 230-237
    CrossrefPubMedGoogle Scholar
  • 92 Bolli G, de Feo P, Compagnucci P. et al. Abnormal glucose counterregulation in insulin-dependent diabetes mellitus. Interaction of anti-insulin antibodies and impaired glucagon and epinephrine secretion. Diabetes 1983; 32: 134-141
    CrossrefPubMedGoogle Scholar
  • 93 Dagogo-Jack S, Rattarasarn C, Cryer PE. Reversal of hypoglycemia unawareness, but not defective glucose counterregulation, in IDDM. Diabetes 1994; 43: 1426-1434
    CrossrefPubMedGoogle Scholar
  • 94 Graveling AJ, Frier BM. Impaired awareness of hypoglycaemia: a review. Diabetes Metab 2010; 36 (Suppl. 03) 74
    Google Scholar
  • 95 Cryer PE. Preventing hypoglycaemia: what is the appropriate glucose alert value?. Diabetologia 2009; 52: 35-37
    CrossrefPubMedGoogle Scholar
  • 96 Conget I, Avila D, Gimenez M. et al. Impaired awareness of hypoglycaemia in subjects with type 1 diabetes. Results of an online survey in a diabetes web site. Endocrinol Nutr 2016; 63: 121-125
    PubMedGoogle Scholar
  • 97 Hendrieckx C, Halliday JA, Bowden JP. et al. Severe hypoglycaemia and its association with psychological well-being in Australian adults with type 1 diabetes attending specialist tertiary clinics. Diabetes Res Clin Prac 2014; 103: 430-436
    CrossrefPubMedGoogle Scholar
  • 98 Ogundipe OO, Geddes J, Leckie AM. et al. Impaired hypoglycaemia awareness and employment in people with type 1 diabetes. Occup Med (Lond) 2011; 61: 241-246
    CrossrefPubMedGoogle Scholar
  • 99 Schopman JE, Geddes J, Frier BM. Prevalence of impaired awareness of hypoglycaemia and frequency of hypoglycaemia in insulin-treated type 2 diabetes. Diabetes Res Clin Pract 2010; 87: 64-68
    PubMedGoogle Scholar
  • 100 Östenson CG, Geelhoed-Duijvestijn P, Lahtela J. et al. Self-reported non-severe hypoglycaemic events in Europe. Diabet Med 2014; 31: 92-101
    CrossrefPubMedGoogle Scholar
  • 101 Kulzer B, Seitz L, Kern W. Real-world patient-reported rates of non-severe hypoglycaemic events in Germany. Exp Clin Endocrinol Diabetes 2014; 122: 167-172
    Article in Thieme ConnectPubMedGoogle Scholar
  • 102 Sommerfield AJ, Deary IJ, Frier BM. Acute hyperglycemia alters mood state and impairs cognitive performance in people with type 2 diabetes. Diabetes Care 2004; 27: 2335-2340
    CrossrefPubMedGoogle Scholar
  • 103 Clarke WL, Cox DJ, Gonder-Frederick LA. et al. Hypoglycemia and the decision to drive a motor vehicle by persons with diabetes. JAMA 1999; 282: 750-754
    CrossrefPubMedGoogle Scholar
  • 104 Evans ML, Pernet A, Lomas J. et al. Delay in onset of awareness of acute hypoglycemia and of restoration of cognitive performance during recovery. Diabetes Care 2000; 23: 893-897
    CrossrefPubMedGoogle Scholar
  • 105 Zammitt NN, Warren RE, Deary IJ. et al. Delayed recovery of cognitive function following hypoglycemia in adults with type 1 diabetes: effect of impaired awareness of hypoglycemia. Diabetes 2008; 57: 732-736
    CrossrefPubMedGoogle Scholar
  • 106 Lobmann R, Smid HG, Pottag G. et al. Impairment and recovery of elementary cognitive function induced by hypoglycemia in type-1 diabetic patients and healthy controls. J Clin Endocrinol Metab 2000; 85: 2758-2766
    CrossrefPubMedGoogle Scholar
  • 107 Pickup J, Mattock M, Kerry S. Glycaemic control with continuous subcutaneous insulin infusion compared with intensive insulin injections in patients with type 1 diabetes: meta-analysis of randomised controlled trials. BMJ 2002; 324: 705
    CrossrefPubMedGoogle Scholar
  • 108 Pickup JC, Sutton AJ. Severe hypoglycaemia and glycaemic control in Type 1 diabetes: meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion. Diabet Med 2008; 25: 765-774
    CrossrefPubMedGoogle Scholar
  • 109 Pickup JC. The evidence base for diabetes technology: appropriate and inappropriate meta-analysis. J Diabetes Sci Technol 2013; 7: 1567-1574
    CrossrefPubMedGoogle Scholar
  • 110 Garg S, Brazg RL, Bailey TS. et al. Reduction in duration of hypoglycemia by automatic suspension of insulin delivery: the in-clinic ASPIRE study. Diabetes Technol Ther 2012; 14: 205-209
    CrossrefPubMedGoogle Scholar
  • 111 Danne T, Tsioli C, Kordonouri O. et al. The PILGRIM study: in silico modeling of a predictive low glucose management system and feasibility in youth with type 1 diabetes during exercise. Diabetes Technol Ther 2014; 16: 338-347
    CrossrefPubMedGoogle Scholar
  • 112 van Beers CAJ, DeVries JH, Kleijer SJ. et al. Continuous glucose monitoring for patients with type 1 diabetes and impaired awareness of hypoglycaemia (IN CONTROL): a randomised, open-label, crossover trial. Lancet Diabetes Endocrinol 2016; 4: 893-902
    CrossrefPubMedGoogle Scholar
  • 113 Šoupal J, Petruzelkova L, Flekac M. et al. Comparison of different treatment modalities for type 1 diabetes, including sensor-augmented insulin regimens, in 52 weeks of follow-up: A COMISAIR Study. Diabetes Technol Ther 2016; 18: 532-538
    CrossrefPubMedGoogle Scholar
  • 114 Bolinder J, Antuna R, Geelhoed-Duijvestijn P. et al. Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial. Lancet 2016; 388: 2254-2263
    CrossrefPubMedGoogle Scholar
  • 115 Cox DJ, Kovatchev BP, Gonder-Frederick LA. et al. Relationships between hyperglycemia and cognitive performance among adults with type 1 and type 2 diabetes. Diabetes Care 2005; 28: 71-77
    CrossrefPubMedGoogle Scholar
  • 116 Okamoto F, Sone H, Nonoyama T. et al. Refractive changes in diabetic patients during intensive glycaemic control. Br J Ophthalmol 2000; 84: 1097-1102
    CrossrefPubMedGoogle Scholar
  • 117 Sonmez B, Bozkurt B, Atmaca A. et al. Effect of glycemic control on refractive changes in diabetic patients with hyperglycemia. Cornea 2005; 24: 531-537
    CrossrefPubMedGoogle Scholar
  • 118 Huntjens B, Charman WN, Workman H. et al. Short-term stability in refractive status despite large fluctuations in glucose levels in diabetes mellitus type 1 and 2. PLoS One 2012; 7: e52947
    CrossrefPubMedGoogle Scholar
  • 119 Mehta VV, Hull CC, Lawrenson JG. The effect of varying glucose levels on the ex vivo crystalline lens: implications for hyperglycaemia-induced refractive changes. Ophthalmic Physiol Opt 2015; 35: 52-59
    CrossrefPubMedGoogle Scholar
  • 120 Yarbağ A, Yazar H, Akdoğan M. et al. Refractive errors in patients with newly diagnosed diabetes mellitus. Pak J Med Sci 2015; 31: 1481-1484
    PubMedGoogle Scholar
  • 121 Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftli-chen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie Prävention und Therapie von Netzhautkomplikationen bei Diabetes – Langfassung. 2015 Konsultationsfassung, 01. Juli 2015 2. Auflage.
    PubMedGoogle Scholar
  • 122 Hoffman RG, Speelman DJ, Hinnen DA. et al. Changes in cortical functioning with acute hypoglycemia and hyperglycemia in type I diabetes. Diabetes Care 1989; 12: 193-197
    CrossrefPubMedGoogle Scholar
  • 123 Gschwend S, Ryan C, Atchison J. et al. Effects of acute hyperglycemia on mental efficiency and counterregulatory hormones in adolescents with insulin-dependent diabetes mellitus. J Pediatr 1995; 126: 178-184
    CrossrefPubMedGoogle Scholar
  • 124 Hewer W, Mussell M, Rist F. et al. Short-term effects of improved glycemic control on cognitive function in patients with type 2 diabetes. Gerontology 2003; 49: 86-92
    CrossrefPubMedGoogle Scholar
  • 125 Bressler NM, Varma R, Mitchell P. et al. Effect of Ranibizumab on the decision to drive and vision function relevant to driving in patients with diabetic macular edema: Report from RESTORE, RIDE, and RISE Trials. JAMA Ophthalmol 2016; 134: 1-7
    Google Scholar
  • 126 Vernon SA, Bhagey J, Boraik M. et al. Long-term review of driving potential following bilateral panretinal photocoagulation for proliferative diabetic retinopathy. Diabet Med 2009; 26: 97-99
    CrossrefPubMedGoogle Scholar
  • 127 Barsam A, Laidlaw A. Visual fields in patients who have undergone vitrectomy for complications of diabetic retinopathy. A prospective study. BMC Ophthalmol 2006; 6: 5
    CrossrefPubMedGoogle Scholar
  • 128 Spiess KE, Sansosti LE, Meyr AJ. Diabetic Driving Studies-Part 2: A Comparison of Brake Response Time Between Drivers With Diabetes With and Without Lower Extremity Sensorimotor Neuropathy. J Foot Ankle Surg 2017; 56: 573-576
    CrossrefPubMedGoogle Scholar
  • 129 Sansosti LE, Spiess KE, Meyr AJ. Diabetic Driving Studies-Part 3: A Comparison of Mean Brake Response Time Between Neuropathic Diabetic Drivers With and Without Foot Pathology. J Foot Ankle Surg 2017; 56: 577-580
    CrossrefPubMedGoogle Scholar
  • 130 Cho SC, Katzberg HD, Rama A. et al. Driving with polyneuropathy. Muscle Nerve 2010; 41: 324-328
    CrossrefPubMedGoogle Scholar
  • 131 Wick JP, Vernon DD. Visual impairment and driving restrictions. Digit J Ophthalmol 2002 8.
    PubMedGoogle Scholar
  • 132 Banning AS, Ng GA. Driving and arrhythmia: A review of scientific basis for international guidelines. Eur Heart J 2013; 34: 236-244
    CrossrefPubMedGoogle Scholar
  • 133 Meikle B, Devlin M, Pauley T. Driving pedal reaction times after right transtibial amputations. Arch Phys Med Rehabil 2006; 87: 390-394
    CrossrefPubMedGoogle Scholar
  • 134 Bundesministerium der Justiz und für Verbraucherschutz. Verordnung über Kraftfahrzeughilfe zur beruflichen Rehabilitation (Kraftfahrzeughilfe-Verordnung – KfzHV). http://www.gesetze-im-internet.de/kfzhv/BJNR022510987.html . Accessed 1 Jun 2016
    Google Scholar
  • 135 Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie Neuropathie bei Diabetes im Erwachsenenalter – Langfassung. 2011 zuletzt verändert: Januar 2015 1. Auflage. Version 4.
    PubMedGoogle Scholar
  • 136 Deutsche Gesellschaft für Neurologie (DGN). Diagnostik bei Polyneuropathien: Erkrankungen peripherer Nerven. 2012
    PubMedGoogle Scholar
  • 137 Boyle J, Eriksson MEV, Gribble L. et al. Randomized, placebo-controlled comparison of amitriptyline, duloxetine, and pregabalin in patients with chronic diabetic peripheral neuropathic pain: impact on pain, polysomnographic sleep, daytime functioning, and quality of life. Diabetes Care 2012; 35: 2451-2458
    CrossrefPubMedGoogle Scholar
  • 138 Bundesärztekammer (BÄK) Arbeitsgemeinschaft der Deutschen Ärztekammern, Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie Typ-2-Diabetes: Präventions- und Behandlungsstrategien für Fußkomplikationen (Langfassung). 2010 2nd ed.
    Google Scholar
  • 139 National Highway Traffic Safety Administration, American Association of Motor Vehicle Administrators. Driver Fitness Medical Guidelines. 2009
    PubMedGoogle Scholar
  • 140 Rod Fleury T, Favrat B, Belaieff W. et al. Resuming motor vehicle driving following orthopaedic surgery or limb trauma. Swiss Med Wkly 2012; 142: w13716
    PubMedGoogle Scholar
  • 141 Petch MC. Driving and heart disease. Eur Heart J 1998; 19: 1165-1177
    CrossrefPubMedGoogle Scholar
  • 142 Epstein AE, Miles WM, Benditt DG. et al. Personal and public safety issues related to arrhythmias that may affect consciousness: implications for regulation and physician recommendations. A medical/scientific statement from the American Heart Association and the North American Society of Pacing and Electrophysiology. Circulation 1996; 94: 1147-1166
    CrossrefPubMedGoogle Scholar
  • 143 Zografos TA, Katritsis DG. Guidelines and regulations for driving in heart disease. Hellenic J Cardiol 2010; 51: 226-234
    PubMedGoogle Scholar
  • 144 Simpson C, Dorian P, Gupta A. et al. Assessment of the cardiac patient for fitness to drive: drive subgroup executive summary. Can J Cardiol 2004; 20: 1314-1320
    PubMedGoogle Scholar
  • 145 Klein HH, Krämer A, Pieske BM. et al. Fahreignung bei kardiovaskulären Erkrankungen. Kardiologe 2010; 4: 441-473
    CrossrefGoogle Scholar
  • 146 Desouza CV, Bolli GB, Fonseca V. Hypoglycemia, diabetes, and cardiovascular events. Diabetes Care 2010; 33: 1389-1394
    CrossrefPubMedGoogle Scholar
  • 147 Cha SA, Yun JS, Lim TS. et al. Severe hypoglycemia and cardiovascular or all-cause mortality in patients with type 2 diabetes. Diabetes Metab J 2016; 40: 202-210
    CrossrefPubMedGoogle Scholar
  • 148 Antonopoulos CN, Sergentanis TN, Daskalopoulou SS. et al. Nasal continuous positive airway pressure (nCPAP) treatment for obstructive sleep apnea, road traffic accidents and driving simulator performance: a meta-analysis. Sleep Med Rev 2011; 15: 301-310
    CrossrefPubMedGoogle Scholar
  • 149 West SD, Nicoll DJ, Stradling JR. Prevalence of obstructive sleep apnoea in men with type 2 diabetes. Thorax 2006; 61: 945-950
    CrossrefPubMedGoogle Scholar
  • 150 Khandelwal D, Dutta D, Chittawar S. et al. Sleep Disorders in Type 2 Diabetes. Indian J Endocrinol Metab 2017; 21: 758-761
    CrossrefPubMedGoogle Scholar
  • 151 Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991; 14: 540-545
    CrossrefPubMedGoogle Scholar
  • 152 Netzer NC, Stoohs RA, Netzer CM. et al. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 1999; 131: 485-491
    CrossrefPubMedGoogle Scholar
  • 153 Stradling J. Driving and obstructive sleep apnoea. Thorax 2008; 63: 481-483
    CrossrefPubMedGoogle Scholar
  • 154 Strohl KP, Brown DB, Collop N. et al. An official American Thoracic Society Clinical Practice Guideline: sleep apnea, sleepiness, and driving risk in noncommercial drivers. An update of a 1994 Statement. Am J Respir Crit Care Med 2013; 187: 1259-1266
    CrossrefPubMedGoogle Scholar
  • 155 Brunnauer A, Laux G, David I. et al. The impact of reboxetine and mirtazapine on driving simulator performance and psychomotor function in depressed patients. J Clin Psychiatry 2008; 69: 1880-1886
    CrossrefPubMedGoogle Scholar
  • 156 Iwamoto K, Takahashi M, Nakamura Y. et al. The effects of acute treatment with paroxetine, amitriptyline, and placebo on driving performance and cognitive function in healthy Japanese subjects: a double-blind crossover trial. Hum Psychopharmacol 2008; 23: 399-407
    CrossrefPubMedGoogle Scholar
  • 157 Kulzer B, Albus C, Herpertz S. et al. Psychosoziales und Diabetes (Teil 1). Diabetologie und Stoffwechsel 2013; 8: 198-242
    Article in Thieme ConnectGoogle Scholar
  • 158 Laux G, Brunnauer A. Fahrtauglichkeit unter Antidepressiva: Ein Update unter Berücksichtigung des neuen Antidepressivums Vortioxetin. Psychopharmakotherapie 2015; 22: 35-41
    Google Scholar
  • 159 Brunnauer A, Laux G. The effects of most commonly prescribed second generation antidepressants on driving ability: a systematic review: 70th Birthday Prof. Riederer. J Neural Transm (Vienna) 2013; 120: 225-232
    CrossrefPubMedGoogle Scholar
  • 160 Verster JC, Mets MAJ. Psychoactive medication and traffic safety. Int J Environ Res Public Health 2009; 6: 1041-1054
    CrossrefPubMedGoogle Scholar
  • 161 DGPPN, BÄK, KBV, AWMF, AkdÄ, BPtK, BApK, DAGSHG, DEGAM, DGPM, DGPs, DGRW (Hrsg) für die Leitliniengruppe Unipolare Depression. S3-Leitlinie/Nationale VersorgungsLeitlinie Unipolare Depression – Langfassung. November 2015 2. Auflage, Version 1.
    Google Scholar
  • 162 Biessels GJ, Staekenborg S, Brunner E. et al. Risk of dementia in diabetes mellitus: a systematic review. Lancet Neurol 2006; 5: 64-74
    CrossrefPubMedGoogle Scholar
  • 163 Man-Son-Hing M, Marshall SC, Molnar FJ. et al. Systematic review of driving risk and the efficacy of compensatory strategies in persons with dementia. J Am Geriatr Soc 2007; 55: 878-884
    CrossrefPubMedGoogle Scholar
  • 164 Wild K, Cotrell V. Identifying driving impairment in Alzheimer disease: a comparison of self and observer reports versus driving evaluation. Alzheimer Dis Assoc Disord 2003; 17: 27-34
    CrossrefPubMedGoogle Scholar
  • 165 Prinz N, Stingl J, Dapp A. et al. High rate of hypoglycemia in 6770 type 2 diabetes patients with comorbid dementia: A multicenter cohort study on 215932 patients from the German/Austrian diabetes registry. Diabetes Res Clin Prac 2016; 112: 73-81
    CrossrefPubMedGoogle Scholar
  • 166 DGPPN, DGN, Deutschen Alzheimer Gesellschaft e.V. – Selbsthilfe Demenz (Hrsg). S3-Leitlinie „Demenzen“ (Langversion – November 2009).
    Google Scholar
  • 167 DGPPN, DGN, Deutschen Alzheimer Gesellschaft e.V. – Selbsthilfe Demenz (Hrsg). S3-Leitlinie „Demenzen“ (Langversion – 1. Revision, August 2015) – Konsentierungsversion für öffentliche Kommentierung.
    Google Scholar
  • 168 Iverson DJ, Gronseth GS, Reger MA. et al. Practice parameter update: evaluation and management of driving risk in dementia: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2010; 74: 1316-1324
    CrossrefPubMedGoogle Scholar
  • 169 Kilpatrick ES, Rigby AS, Warren RE. et al. Implications of new European Union driving regulations on patients with Type 1 diabetes who participated in the Diabetes Control and Complications Trial. Diabet Med 2013; 30: 616-619
    CrossrefPubMedGoogle Scholar
  • 170 Hemmelgarn B, Lévesque LE, Suissa S. Anti-diabetic drug use and the risk of motor vehicle crash in the elderly. Can J Clin Pharmacol 2006; 13: 20
    Google Scholar
  • 171 Bremer JP, Jauch-Chara K, Hallschmid M. et al. Hypoglycemia unawareness in older compared with middle-aged patients with type 2 diabetes. Diabetes Care 2009; 32: 1513-1517
    CrossrefPubMedGoogle Scholar
  • 172 Statistisches Bundesamt. Verkehrsunfälle. Unfälle von 15- 17-Jährigen im Straßenverkehr 2015. 2016 https://www.destatis.de/DE/Publikationen/Thematisch/TransportVerkehr/Verkehrsunfaelle/Unfaelle15bis17jaehrigen.html . Accessed 14 Jun 2017
    PubMedGoogle Scholar
  • 173 Statistisches Bundesamt. Verkehrsunfälle. Unfälle von 18- 24-Jährigen im Straßenverkehr 2015. 2016 https://www.destatis.de/DE/Publikationen/Thematisch/TransportVerkehr/Verkehrsunfaelle/Unfaelle18bis24jaehrigen.html . Accessed 14 Jun 2017
    PubMedGoogle Scholar
  • 174 Holl RW PN. Gesundheitsbericht Diabetes 2016. 2015
    PubMedGoogle Scholar
  • 175 Fritsch M, Rosenbauer J, Schober E. et al. Predictors of diabetic ketoacidosis in children and adolescents with type 1 diabetes. Experience from a large multicentre database. Pediatr Diabetes 2011; 12: 307-312
    CrossrefPubMedGoogle Scholar
  • 176 Maahs DM, Hermann JM, Holman N. et al. Rates of Diabetic Ketoacidosis: International Comparison With 49859 Pediatric Patients With Type 1 Diabetes From England, Wales, the U.S., Austria, and Germany. Diabetes Care 2015; 38: 1876-1882
    CrossrefPubMedGoogle Scholar
  • 177 Chilton R, Pires-Yfantouda R. Understanding adolescent type 1 diabetes self-management as an adaptive process: A grounded theory approach. Psychol Health 2015; 30: 1486-1504
    CrossrefPubMedGoogle Scholar
  • 178 Gabele A, Budde J, Spichiger E. Transition von der Kindheit zur Adoleszenz – eine qualitative Studie zum Erleben von Adoleszenten mit Typ 1 Diabetes mellitus und ihren Müttern. Pflege 2015; 28: 69-78
    CrossrefPubMedGoogle Scholar
  • 179 Statistisches Bundesamt. Unfälle von Senioren im Straßenverkehr. https://www.destatis.de/DE/Publikationen/Thematisch/TransportVerkehr/Verkehrsunfaelle/UnfaelleSenioren.html . Accessed 27 Oct 2015
    Google Scholar
  • 180 Rees S, Browne A, Major HG. et al. Renewal of driving licences and long duration insulin-treated diabetes: A comparison of medical assessment and self-reporting by drivers. Practical Diabetes 2012; 29: 117-119
    CrossrefGoogle Scholar
  • 181 Meyr AJ, Spiess KE. Diabetic Driving Studies-Part 1: Brake Response Time in Diabetic Drivers With Lower Extremity Neuropathy. J Foot Ankle Surg 2017; 56: 568-572
    CrossrefPubMedGoogle Scholar
  • 182 Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie Diabetes –Strukturierte Schulungsprogramme – Langfassung. 2012 zuletzt geändert: Juni 2013: Bundesärztekammer (BÄK); Kassenärztliche Bundesvereinigung (KBV); Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) 1. Auflage. Version 3.
    PubMedGoogle Scholar
  • 183 Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie Diabetes. Strukturierte Schulungsprogramme – Langfassung. 2012 Version 1.0. DOI: 10.6101/AZQ/000083
    CrossrefGoogle Scholar
  • 184 Cox DJ, Gonder-Frederick L, Julian DM. et al. Long-term follow-up evaluation of blood glucose awareness training. Diabetes Care 1994; 17: 1-5
    CrossrefPubMedGoogle Scholar
  • 185 Broers S, Le Cessie S, van Vliet KP. et al. Blood Glucose Awareness Training in Dutch Type 1 diabetes patients. Short-term evaluation of individual and group training. Diabet Med 2002; 19: 157-161
    CrossrefPubMedGoogle Scholar
  • 186 Broers S, van Vliet KP, Le Cessie S. et al. Blood glucose awareness training in Dutch type 1 diabetes patients: one-year follow-up. Neth J Med 2005; 63: 164-169
    PubMedGoogle Scholar
  • 187 Bundesministerium der Justiz und für Verbraucherschutz. Bürgerliches Gesetzbuch (BGB), § 630e Aufklärungspflichten Abs. 1.
    Google Scholar
  • 188 Bundesministerium der Justiz und für Verbraucherschutz. Bürgerliches Gesetzbuch (BGB), § 630e Aufklärungspflichten Abs. 2 Nr. 3 (BT-Drs. 17/10488, S. 25).
    Google Scholar
  • 189 Bundesministerium der Justiz und für Verbraucherschutz. Bürgerliches Gesetzbuch (BGB), § 630e Aufklärungspflichten Abs. 2 Nr. 1.
    Google Scholar
  • 190 Bundesministerium der Justiz und für Verbraucherschutz. Bürgerliches Gesetzbuch (BGB), § 630e Aufklärungspflichten Abs. 2.
    Google Scholar
  • 191 Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG). Vorbericht (vorläufige Nutzenbewertung) D12-01: Kontinuierliche Glukosemessung (CGM) mit Real-Time-Messgeräten. 2014
    PubMedGoogle Scholar
  • 192 Bundesministerium der Justiz und für Verbraucherschutz. Verordnung über die Zulassung von Personen zum Straßenverkehr (Fahrerlaubnis-Verordnung – FeV) vom 13.12.2010 (BGBl. I S. 1980). Stand 30.09.2017 (BGBl. I S. 3532)
    Google Scholar
  • 193 ArbSchG Arbeitsschutzgesetz. Gesetz über die Durchführung von Maßnahmen des Arbeitsschutzes zur Verbesserung der Sicherheit und des Gesundheitsschutzes der Beschäftigten bei der Arbeit (Arbeitsschutzgesetz – ArbSchG) vom 07.08.1996 (BGBl. I 1246), geändert durch Artikel 8 des Gesetzes vom 19.10.2013 (BGBl. I S. 3836). 2013
    PubMedGoogle Scholar
  • 194 Bergenstal RM, Klonoff DC, Garg SK. et al. Threshold-based insulin-pump interruption for reduction of hypoglycemia. N Engl J Med 2013; 369: 224-232
    CrossrefPubMedGoogle Scholar
  • 195 Deutsche Gesetzliche Unfallversicherung e.V. (DGUV). Leitfaden für Betriebsärzte zu Diabetes und Beruf. 2012
    PubMedGoogle Scholar
  • 196 Richtlinie 2006/126/EG des Europäischen Parlaments und des Rates vom 20. Dezember 2006 über den Führerschein (Neufassung). Zuletzt geändert durch Art. 1 ÄndRL (EU) 2016/1106 vom 7. 7. 2016 (ABl. Nr. L 183 S. 59). http://eur-lex.europa.eu/legal-content/DE/TXT/?uri=CELEX:32006L0126 . Accessed 16 Oct 2017
    Google Scholar
  • 197 Seaquist ER, Anderson J, Childs B. et al. Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. J Clin Endocrinol Metab 2013; 98: 1845-1859
    CrossrefPubMedGoogle Scholar
  • 198 Frier BM. Defining hypoglycaemia: what level has clinical relevance?. Diabetologia 2009; 52: 31-34
    CrossrefPubMedGoogle Scholar
  • 199 Swinnen SGHA, Mullins P, Miller M. et al. Changing the glucose cut-off values that define hypoglycaemia has a major effect on reported frequencies of hypoglycaemia. Diabetologia 2009; 52: 38-41
    CrossrefPubMedGoogle Scholar
  • 200 Freckmann G, Baumstark A, Jendrike N. et al. System accuracy evaluation of 27 blood glucose monitoring systems according to DIN EN ISO 15197. Diabetes Technol Ther 2010; 12: 221-231
    CrossrefPubMedGoogle Scholar
  • 201 Freckmann G, Schmid C, Baumstark A. et al. Analytical performance requirements for systems for self-monitoring of blood glucose with focus on system accuracy: relevant differences among ISO 15197:2003, ISO 15197:2013, and current FDA recommendations. J Diabetes Sci Techno 2015; 9: 885-894
    Google Scholar
  • 202 Frier BM. Hypoglycaemia in diabetes mellitus: epidemiology and clinical implications. Nat Rev Endocrino 2014; 10: 711-722
    Google Scholar
  • 203 Committee for Medicinal Products for Human Use (CHMP). Guideline on clinical investigation of medical products in the treatment or prevention of diabetes mellitus. 2012 http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2012/06/WC500129256.pdf . Accessed 4 Jan 2017
    PubMedGoogle Scholar
  • 204 Elliott L, Fidler C, Ditchfield A. et al. Hypoglycemia event rates: a comparison between real-world data and randomized controlled trial populations in insulin-treated diabetes. Diabetes Ther 2016; 7: 45-60
    CrossrefPubMedGoogle Scholar
  • 205 Janssen MM, Snoek FJ, de Jongh RT. et al. Biological and behavioural determinants of the frequency of mild, biochemical hypoglycaemia in patients with type 1 diabetes on multiple insulin injection therapy. Diabetes Metab Res Rev 2000; 16: 157-163
    CrossrefPubMedGoogle Scholar
  • 206 Edridge CL, Dunkley AJ, Bodicoat DH. et al. Prevalence and incidence of hypoglycaemia in 532542 people with type 2 diabetes on oral therapies and insulin: a systematic review and meta-analysis of population based studies. PLoS One 2015; 10: e0126427
    CrossrefPubMedGoogle Scholar
  • 207 Khunti K, Alsifri S, Aronson R. et al. Rates and predictors of hypoglycaemia in 27 585 people from 24 countries with insulin-treated type 1 and type 2 diabetes: the global HAT study. Diabetes Obes Metab 2016; 18: 907-915
    CrossrefPubMedGoogle Scholar
  • 208 Bohn B, Kerner W, Seufert J. et al. Trend of antihyperglycaemic therapy and glycaemic control in 184.864 adults with type 1 or 2 diabetes between 2002 and 2014: Analysis of real-life data from the DPV registry from Germany and Austria. Diabetes Res Clin Pract 2016; 115: 31-38
    CrossrefPubMedGoogle Scholar
  • 209 UK Hypoglycemia Study Group. Risk of hypoglycaemia in types 1 and 2 diabetes: effects of treatment modalities and their duration. Diabetologia 2007; 50: 1140-1147
    CrossrefPubMedGoogle Scholar
  • 210 Sämann A, Lehmann T, Heller T. et al. A retrospective study on the incidence and risk factors of severe hypoglycemia in primary care. Fam Pract 2013; 30: 290-293
    CrossrefPubMedGoogle Scholar
  • 211 Holstein A, Plaschke A, Egberts EH. Clinical characterisation of severe hypoglycaemia--a prospective population-based study. Exp Clin Endocrinol Diabetes 2003; 111: 364-369
    Article in Thieme ConnectPubMedGoogle Scholar
  • 212 Holstein A, Patzer OM, Machalke K. et al. Substantial increase in incidence of severe hypoglycemia between 1997-2000 and 2007–2010: a German longitudinal population-based study. Diabetes Care 2012; 35: 972-975
    CrossrefPubMedGoogle Scholar
  • 213 Zaccardi F, Davies MJ, Dhalwani NN. et al. Trends in hospital admissions for hypoglycaemia in England: a retrospective, observational study. Lancet Diabetes Endocrinol 2016; 4: 677-685
    CrossrefPubMedGoogle Scholar
  • 214 The DCCT Research Group. Diabetes Control and Complications Trial (DCCT): results of feasibility study. The DCCT Research Group. Diabetes Care 1987; 10: 1-19
    CrossrefPubMedGoogle Scholar
  • 215 The DCCT Research Group. Epidemiology of severe hypoglycemia in the diabetes control and complications trial. The DCCT Research Group. Am J Med 1991; 90: 450-459
    CrossrefPubMedGoogle Scholar
  • 216 Bragd J, Adamson U, Lins PE. et al. A repeated cross-sectional survey of severe hypoglycaemia in 178 type 1 diabetes mellitus patients performed in 1984 and 1998. Diabet Med 2003; 20: 216-219
    CrossrefPubMedGoogle Scholar
  • 217 Schiel R, Müller UA, Sprott H. et al. The JEVIN trial: a population-based survey on the quality of diabetes care in Germany: 1994/1995 compared to 1989/1990. Diabetologia 1997; 40: 1350-1357
    CrossrefPubMedGoogle Scholar
  • 218 Plank J, Köhler G, Rakovac I. et al. Long-term evaluation of a structured outpatient education programme for intensified insulin therapy in patients with Type 1 diabetes: a 12-year follow-up. Diabetologia 2004; 47: 1370-1375
    PubMedGoogle Scholar
  • 219 Benkhadra K, Alahdab F, Tamhane SU. et al. Continuous subcutaneous insulin infusion versus multiple daily injections in individuals with type 1 diabetes: a systematic review and meta-analysis. Endocrine 2017; 55: 77-84
    CrossrefPubMedGoogle Scholar
  • 220 Patel A, MacMahon S, Chalmers J. et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 2008; 358: 2560-2572
    CrossrefPubMedGoogle Scholar
  • 221 Gerstein HC, Miller ME, Byington RP. et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 2008; 358: 2545-2559
    CrossrefPubMedGoogle Scholar
  • 222 Duckworth W, Abraira C, Moritz T. et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med 2009; 360: 129-139
    CrossrefPubMedGoogle Scholar
  • 223 Krichbaum M. Schwere Hypoglykämien bei Typ-2-Diabetes. Diabetologe 2013; 9: 226-231
    CrossrefGoogle Scholar
  • 224 Choudhary P, Ramasamy S, Green L. et al. Real-time continuous glucose monitoring significantly reduces severe hypoglycemia in hypoglycemia-unaware patients with type 1 diabetes. Diabetes Care 2013; 36: 4160-4162
    CrossrefPubMedGoogle Scholar
  • 225 Scheen AJ. Clinical efficacy of acarbose in diabetes mellitus: a critical review of controlled trials. Diabetes Metab 1998; 24: 311-320
    PubMedGoogle Scholar
  • 226 Joshi SR, Ramachandran A, Chadha M. et al. Acarbose plus metformin fixed-dose combination in the management of type 2 diabetes. Expert Opin Pharmacother 2014; 15: 1611-1620
    CrossrefPubMedGoogle Scholar
  • 227 Weng J, Soegondo S, Schnell O. et al. Efficacy of acarbose in different geographical regions of the world: analysis of a real-life database. Diabetes Metab Res Rev 2015; 31: 155-167
    CrossrefPubMedGoogle Scholar
  • 228 Patel SS. Cerebrovascular complications of diabetes: alpha glucosidase inhibitor as potential therapy. Horm Metab Res 2016; 48: 83-91
    Article in Thieme ConnectPubMedGoogle Scholar
  • 229 Wiernsperger NF, Bailey CJ. The antihyperglycaemic effect of metformin: therapeutic and cellular mechanisms. Drugs 1999; 58 (Suppl. 01) 31-39 ; discussion 75–82
    PubMedGoogle Scholar
  • 230 Andújar-Plata P, Pi-Sunyer X, Laferrère B. Metformin effects revisited. Diabetes Res Clin Pract 2012; 95: 1-9
    CrossrefPubMedGoogle Scholar
  • 231 Scheen AJ, Paquot N. Metformin revisited: a critical review of the benefit-risk balance in at-risk patients with type 2 diabetes. Diabetes Metab 2013; 39: 179-190
    CrossrefPubMedGoogle Scholar
  • 232 Bailey CJ. Metformin: historical overview. Diabetologia 2017; 60: 1566-1576
    CrossrefPubMedGoogle Scholar
  • 233 Ezer M, Yıldırım LT, Bayro O. et al. Synthesis and antidiabetic activity of morpholinothiazolyl-2,4-thiazolidindione derivatives. J Enzyme Inhib Med Chem 2012; 27: 419-427
    CrossrefPubMedGoogle Scholar
  • 234 Klotz U, Sailer D. Arzneimittelinteraktionen--ihre Bedeutung für eine sichere Therapie am Beispiel der neuen Wirkstoffgruppe der Thiazolidindione (Glitazone). Arzneimittelforschung 2001; 51: 112-117
    Article in Thieme ConnectPubMedGoogle Scholar
  • 235 Karagiannis T, Paschos P, Paletas K. et al. Dipeptidyl peptidase-4 inhibitors for treatment of type 2 diabetes mellitus in the clinical setting: systematic review and meta-analysis. BMJ 2012; 344: e1369
    CrossrefPubMedGoogle Scholar
  • 236 Kawalec P, Mikrut A, Łopuch S. The safety of dipeptidyl peptidase-4 (DPP-4) inhibitors or sodium-glucose cotransporter 2 (SGLT-2) inhibitors added to metformin background therapy in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetes Metab Res Rev 2014; 30: 269-283
    CrossrefPubMedGoogle Scholar
  • 237 Wu D, Li L, Liu C. Efficacy and safety of dipeptidyl peptidase-4 inhibitors and metformin as initial combination therapy and as monotherapy in patients with type 2 diabetes mellitus: a meta-analysis. Diabetes Obes Metab 2014; 16: 30-37
    CrossrefPubMedGoogle Scholar
  • 238 Cahn A, Cernea S, Raz I. An update on DPP-4 inhibitors in the management of type 2 diabetes. Expert Opin Emerg Drugs 2016; 21: 409-419
    CrossrefPubMedGoogle Scholar
  • 239 Rosenwasser RF, Sultan S, Sutton D. et al. SGLT-2 inhibitors and their potential in the treatment of diabetes. Diabetes Metab Syndr Obes 2013; 6: 453-467
    PubMedGoogle Scholar
  • 240 Scheen AJ. Pharmacodynamics, efficacy and safety of sodium-glucose co-transporter type 2 (SGLT2) inhibitors for the treatment of type 2 diabetes mellitus. Drugs 2015; 75: 33-59
    CrossrefPubMedGoogle Scholar
  • 241 Nathan KT, Ahmed-Sarwar N, Werner P. SGLT-2 Inhibitors: A Novel Mechanism in Targeting Glycemic Control in Type 2 Diabetes Mellitus. Consult Pharm 2016; 31: 251-260
    CrossrefPubMedGoogle Scholar
  • 242 Nauck M. Incretin therapies: highlighting common features and differences in the modes of action of glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors. Diabetes Obes Metab 2016; 18: 203-216
    CrossrefPubMedGoogle Scholar
  • 243 Howse PM, Chibrikova LN, Twells LK. et al. Safety and Efficacy of Incretin-Based Therapies in Patients With Type 2 Diabetes Mellitus and CKD: A Systematic Review and Meta-analysis. Am J Kidney Dis 2016; 68: 733-742
    CrossrefPubMedGoogle Scholar
  • 244 Zhang Z, Chen X, Lu P. et al. Incretin-based agents in type 2 diabetic patients at cardiovascular risk: compare the effect of GLP-1 agonists and DPP-4 inhibitors on cardiovascular and pancreatic outcomes. Cardiovasc Diabetol 2017; 16: 31
    CrossrefPubMedGoogle Scholar
  • 245 Mehlhorn AJ, Brown DA. Safety concerns with fluoroquinolones. Ann Pharmacother 2007; 41: 1859-1866
    CrossrefPubMedGoogle Scholar
  • 246 Murad MH, Coto-Yglesias F, Wang AT. et al. Clinical review: Drug-induced hypoglycemia: a systematic review. J Clin Endocrinol Metab 2009; 94: 741-745
    CrossrefPubMedGoogle Scholar
  • 247 Shorr RI, Ray WA, Daugherty JR. et al. Antihypertensives and the risk of serious hypoglycemia in older persons using insulin or sulfonylureas. JAMA 1997; 278: 40-43
    CrossrefPubMedGoogle Scholar
  • 248 Li J, Zhang N, Ye B. et al. Non-steroidal anti-inflammatory drugs increase insulin release from beta cells by inhibiting ATP-sensitive potassium channels. Br J Pharmacol 2007; 151: 483-493
    PubMedGoogle Scholar