Editor—The DIGAMI study (diabetes mellitus insulin glucose infusion in acute myocardial infarction) suggested that insulin treatment at the time of myocardial infarction offered some improvement in mortality, particularly in patients not previously treated with insulin.1 As a result of this study insulin has been started acutely after myocardial infarction in many such patients.
Any patient who starts taking insulin is legally obliged to inform the Driver and Vehicle Licensing Agency, and the standard advice is that he or she should not drive for at least a month. As many patients are advised not to drive for at least this period after infarction there may be no immediate concern. Many of these patients are, however, treated with insulin for several months, and some of them seem to be unaware of their obligations regarding driving.
We would urge that all patients who are advised to start taking insulin are referred quickly for expert diabetological advice; in particular, they should be advised about their legal obligation as regards informing the Driver and Vehicle Licensing Agency. There is a risk of hypoglycaemia, and this risk would be diminished by early referral for expert advice on stabilisation and adjustment of insulin doses.
Footnotes
On behalf of the Honorary Medical Advisory Panel on Driving and Diabetes Mellitus
References
- 1.Malmberg K.for the DIGAMI (Diabetes Mellitus Insulin Glucose Infusion in Acute Myocardial Infarction) Study Group. Prospective randomised study of intensive insulin treatment on long term survival after acute myocardial infarction in patients with diabetes mellitus BMJ 19973141512–1515. [DOI] [PMC free article] [PubMed] [Google Scholar]