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Letter to the Editor

Published:April 20, 2018DOI:https://doi.org/10.1053/j.jfas.2017.12.018
      We have read the article entitled “Diabetic Driving Studies—Part 1: Brake Response Time in Diabetic Drivers With Lower Extremity Neuropathy” (JFAS 56:568–572, 2017) published in the May/June issue of your Journal with outmost interest because it has presented the data from a valuable and important study in an attempt to find an answer to a substantial question.
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      • Diabetic Driving Studies—Part 1: Brake Response Time in Diabetic Drivers With Lower Extremity Neuropathy
        The Journal of Foot and Ankle SurgeryVol. 56Issue 3
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          Although the effect of lower extremity pathology and surgical intervention on automobile driving function has been a topic of contemporary interest, we are unaware of any analysis of the effect of lower extremity diabetic sensorimotor neuropathy on driving performance. The objective of the present case-control investigation was to assess the mean brake response time in diabetic drivers with lower extremity neuropathy compared with that of a control group and a brake response safety threshold. The driving performances of participants were evaluated using a computerized driving simulator with specific measurement of the mean brake response time and frequency of abnormally delayed brake responses.
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      • Author's Reply to Letter to the Editor
        The Journal of Foot and Ankle SurgeryVol. 59Issue 2
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          Thanks for your letter and interest in our investigation. We were also surprised that the group with a history of specific diabetic foot pathology (ulceration, partial foot amputation, Charcot neuroarthropathy) relatively outperformed the group with only evidence of lower extremity sensorimotor neuropathy. However, as stated in the Discussion, we continue to believe that this statistically significant finding has limited clinical significance, “as both groups demonstrated mean brake response times in excess of a recommended driving safety threshold of 0.700 seconds.” We are unaware of any investigation (including our own) that has measured the effect of acute blood glucose levels, hypoglycemic events, and/or specific pharmacologic agents on brake response times, and agree that this might represent an interesting avenue for future investigations.
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