David Kerr: Driving in the (near) future

David KerrThe Department of Health has just written to GP’s to encourage them to stop being so mean when it comes to providing blood glucose testing strips to people living with type 1 diabetes. Part of the reasoning for sending the letter relates to guidance from the UK Driving and Vehicle Licensing Agency for patients which states that, “you must always carry your glucose meter and blood glucose strips with you,” and “you must check your blood glucose before the first journey and every two hours.”

The ability to multitask and drive at the same time is about to change. Although huge amounts of time, effort, and cash continue to be spent on developing the uses for smart mobile phones, using a hand held phone whilst driving has been illegal in the UK since 2003. No surprises therefore that, according to recent BBC news reports, the car is the third fastest growing technological device after the smartphone and tablet computer and by 2014 every new car will be connected to the web. Apparently selling points for new motor vehicles will include access to the iTunes store and other forms of “infotainment,” as well as integrated windscreen direction and parking space finders. You will also be able to find the location of the nearest petrol station, compare fuel prices, and find out how long it will take before the traffic light changes from red.

Given the amount of time we spend driving, the car could also become a mobile medical clinic by integrating a driver’s physiology into the mechanical workings of the vehicle. There might be opportunities for real time heart rate and blood pressure monitoring as well as being able to alter in-vehicle oxygen for individuals with lung problems. In my own speciality of diabetes there is already work underway to link glucose monitoring systems to the ignition—the car could be modified so as not to start if a glucose level is below ideal. Furthermore, already available continuous glucose monitoring systems could predict the potential for hypoglycaemia during a car journey, alert the driver by auditory, visual, or tactile alarms and switch on the satellite navigation system to direct the driver to the nearest source of carbohydrate. Another simple option would be in-car alcohol monitoring for individuals convicted previously of driving under the influence of alcohol. In-car recording of high breath or sweat alcohol levels could prevent driving altogether.

The downside of adding these advanced technological features to a car is the potential for distraction. According to John Ellis, global technologist for connected services and solutions at Ford, “the danger is safety—you could get caught up in your experience and forget that you’re driving.” Another negative aspect would be the opportunity for insurers to collect detailed medical information through monitoring systems perhaps leading to higher premiums?  The other major worry is security—being connected to the internet would allow hackers access to your car although manufacturers are claiming that it is possible to separate the internet based features and apps from the important vehicle controlling features. One less-than-reassuring response from the car industry to safety concerns is the idea that if an accident does occur a “mandatory sensor” will call the emergency services to the scene. It is also still unclear whether your new car will come in both Apple and Android versions.

David Kerr wears many hats, sometimes at the same time—diabetologist, editor of Diabetes Digest, researcher, and founder of VoyageMD.com, a free service for travellers with diabetes. You can follow him on Twiitter (@GoDiabetesMD) and Linkedin. He holds a small amount of stock in CellNovo (a new insulin pump company) and Axon Telehealth.

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