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Given the growing prevalence of diabetes, there has been significant interest in determining how diabetes affects instrumental daily functions, like driving. Complication of glucose control in diabetes includes hypoglycemic and hyperglycemic episodes, which may impair cognitive and psychomotor functions needed for safe driving. The goal of this paper was to determine patterns of diabetes speed behavior during acute glucose to drivers with diabetes who were euglycemic or control drivers without diabetes in a naturalistic driving environment. By employing distribution-based analytic methods which capture distribution patterns, our study advances prior literature that has focused on conventional approach of average speed to explore speed deviation patterns., Comment: 6 pages, 2 figures, 5 Tables, Accepted and Presented at IEEE ITSC 2023 Conference in Bilbao Spain

Background: Diabetes is associated with obesity, poor glucose control and sleep dysfunction which impair cognitive and psychomotor functions, and, in turn, increase driver risk. How this risk plays out in the real-world driving settings is terra incognita. Addressing this knowledge gap requires comprehensive observations of diabetes driver behavior and physiology in challenging settings where crashes are more likely to occur, such as stop-controlled traffic intersections, as in the current study of drivers with Type 1 Diabetes (T1DM). Methods: 32 active drivers from around Omaha, NE participated in 4-week, real-world study. Each participant's own vehicle was instrumented with an advanced telematics and camera system collecting driving sensor data and video. Videos were analyzed using computer vision models detecting traffic elements to identify stop signs. Stop sign detections and driver stopping trajectories were clustered to geolocate and extract driver-visited stop intersections. Driver videos were then annotated to record stopping behavior and key traffic characteristics. Stops were categorized as safe or unsafe based on traffic law. Results: Mixed effects logistic regression models examined how stopping behavior (safe vs. unsafe) in T1DM drivers was affected by 1) abnormal sleep, 2) obesity, and 3) poor glucose control. Model results indicate that one standard deviation increase in BMI (~7 points) in T1DM drivers associated with a 14.96 increase in unsafe stopping odds compared to similar controls. Abnormal sleep and glucose control were not associated with increased unsafe stopping. Conclusion: This study links chronic patterns of abnormal T1DM driver physiology, sleep, and health to driver safety risk at intersections, advancing models to identify real-world safety risk in diabetes drivers for clinical intervention and development of in-vehicle safety assistance technology., Comment: 23 pages, 7 figures, 10 tables

The use of naturalistic driving studies (NDSs) for driver behavior research has skyrocketed over the past two decades. Intersections are a key target for traffic safety, with up to 25-percent of fatalities and 50-percent injuries from traffic crashes in the United States occurring at intersections. NDSs are increasingly being used to assess driver behavior at intersections and devise strategies to improve intersection safety. A common challenge in NDS intersection research is the need for to combine spatial locations of driver-visited intersections with concurrent video clips of driver trajectories at intersections to extract analysis variables. The intersection identification and driver trajectory video clip extraction process are generally complex and repetitive. We developed a novel R package called ndsintxn to streamline this process and automate best practices to minimize computational time, cost, and manual labor. This paper provides details on the methods and illustrative examples used in the ndsintxn R package., Comment: 13 pages, 7 figures, 1 table

Diabetes is a major public health challenge worldwide. Abnormal physiology in diabetes, particularly hypoglycemia, can cause driver impairments that affect safe driving. While diabetes driver safety has been previously researched, few studies link real-time physiologic changes in drivers with diabetes to objective real-world driver safety, particularly at high-risk areas like intersections. To address this, we investigated the role of acute physiologic changes in drivers with type 1 diabetes mellitus (T1DM) on safe stopping at stop intersections. 18 T1DM drivers (21-52 years, mean = 31.2 years) and 14 controls (21-55 years, mean = 33.4 years) participated in a 4-week naturalistic driving study. At induction, each participant's vehicle was fitted with a camera and sensor system to collect driving data. Video was processed with computer vision algorithms detecting traffic elements. Stop intersections were geolocated with clustering methods, state intersection databases, and manual review. Videos showing driver stop intersection approaches were extracted and manually reviewed to classify stopping behavior (full, rolling, and no stop) and intersection traffic characteristics. Mixed-effects logistic regression models determined how diabetes driver stopping safety (safe vs. unsafe stop) was affected by 1) disease and 2) at-risk, acute physiology (hypo- and hyperglycemia). Diabetes drivers who were acutely hyperglycemic had 2.37 increased odds of unsafe stopping (95% CI: 1.26-4.47, p = 0.008) compared to those with normal physiology. Acute hypoglycemia did not associate with unsafe stopping (p = 0.537), however the lower frequency of hypoglycemia (vs. hyperglycemia) warrants a larger sample of drivers to investigate this effect. Critically, presence of diabetes alone did not associate with unsafe stopping, underscoring the need to evaluate driver physiology in licensing guidelines., Comment: 18 pages, 3 figures, 8 tables