Multimodal In-Vehicle Hypoglycemia Warning for Drivers With Type 1 Diabetes: Design and Evaluation in Simulated and Real-World Driving

• Published in: JMIR human factors 2024-04, Vol.11, p.e46967-e46967
• Main Authors: Bérubé, Caterina, Maritsch, Martin, Lehmann, Vera Franziska, Kraus, Mathias, Feuerriegel, Stefan, Züger, Thomas, Wortmann, Felix, Stettler, Christoph, Fleisch, Elgar, Kocaballi, A Baki, Kowatsch, Tobias
• Format: Article
• Language: English
• Subjects: Diabetes; Glucose monitoring; Hypoglycemia; Insulin; Lighting; Telematics
• ISSN: 2292-9495; 2292-9495
• DOI: 10.2196/46967

Hypoglycemia threatens cognitive function and driving safety. Previous research investigated in-vehicle voice assistants as hypoglycemia warnings. However, they could startle drivers. To address this, we combine voice warnings with ambient LEDs. The study assesses the effect of in-vehicle multimodal warning on emotional reaction and technology acceptance among drivers with type 1 diabetes. Two studies were conducted, one in simulated driving and the other in real-world driving. A quasi-experimental design included 2 independent variables (blood glucose phase and warning modality) and 1 main dependent variable (emotional reaction). Blood glucose was manipulated via intravenous catheters, and warning modality was manipulated by combining a tablet voice warning app and LEDs. Emotional reaction was measured physiologically via skin conductance response and subjectively with the Affective Slider and tested with a mixed-effect linear model. Secondary outcomes included self-reported technology acceptance. Participants were recruited from Bern University Hospital, Switzerland. The simulated and real-world driving studies involved 9 and 10 participants with type 1 diabetes, respectively. Both studies showed significant results in self-reported emotional reactions (P