News in brief - Jan. 9, 2012

Professional judgment should rule when evaluating driving abilities of patients with diabetes - Independent oversight needed for studies on modified-risk tobacco, IOM says

Professional judgment should rule when evaluating driving abilities of patients with diabetes

State laws requiring physicians to report patients with diabetes who experience severe hypoglycemia to driver's licensing authorities undermine the physician-patient relationship and discourage patients from speaking frankly with their doctors, says an American Diabetes Assn. policy statement in the January Diabetes Care.

Nearly 19 million U.S. residents have diabetes, yet some safety advocates question whether the disease should be a factor in driver's license eligibility, the statement said (care.diabetesjournals.org/content/35/Supplement_1/S81.extract?sid=d4071407-121b-404f-8116-bbd07c9128c0).

At least 23 states ask driver's license applicants if they have diabetes, and most require a medical evaluation for those whose condition could cause altered perception or unconsciousness. Many states allow physicians to decide when to report a patient who may be a driving risk, but some have mandatory reporting laws.

The ability of diabetics to drive should be assessed on a case-by-case basis. Physicians should be able to exercise professional judgment in deciding whether to report a patient for review of driving privileges, the association said.

Independent oversight needed for studies on modified-risk tobacco, IOM says

Companies that manufacture modified-risk tobacco products such as e-cigarettes and tobacco lozenges should use third parties to oversee product research, says a Dec. 14 Institute of Medicine report.

The Family Smoking Prevention and Tobacco Control Act of 2009 requires makers of such products to receive pre-market approval and provide the Food and Drug Administration scientific proof of the benefits of lower-risk tobacco products to users and the general population.

Having independent oversight would help address widespread mistrust of tobacco company-sponsored research and provide some assurance that research submitted to the FDA is reliable, the report said (books.nap.edu/openbook.php?record_id=13294).

"Having trusted third parties oversee the conduct of research could help re-engage scientists and enable a generation of credible research data on the health effects of these products," said Jane Henney, MD, chair of the committee that wrote the report and a professor of medicine and public health sciences at the University of Cincinnati.