Safe Driving with Diabetes

Diabetes and driving

Having diabetes does not mean that you have to give up driving but it does mean that you need to think ahead before you get behind the wheel. The Road Safety Authority (RSA) want to ensure that everyone on the road is fit to drive.

Informing the RSA

Since your treatments and circumstances may change over time, you need to check to see whether you need to tell the RSA about those changes. Your diabetes care team may also advise you to notify the RSA about your fitness to drive. The best way to do this is to contact them directly. It is your responsibility to tell them; however, if you are unable to do this for any reason, your doctor has an obligation to do so on your behalf.

Irish and EU legislation requires that a driver should advise their driver licensing authority of any long-term or permanent injury or illness that may affect their safe driving ability. Diabetes treated by insulin and or sulphonylurea tablets (your doctor can advise whether you are on these or not) needs to be reported to the RSA on application for, or renewal of, a driver licence. If your diabetes is managed by other tablets and/or diet there is no need to inform the RSA.

Changes to your general health can affect your ability to drive such as; visual problems or laser treatment, loss of muscle strength or balance due to a stroke or other serious medical conditions. Some of the complications associated with diabetes, such as loss of sensation in the feet due to nerve damage, frequent or severe hypoglycaemia (low glucose levels) can also affect your ability to drive and this might affect the type of driving licence you have.

You must inform the Licensing Authority if:

• You have diabetes and are being treated with medications
• You suffer more than one episode of severe hypoglycaemia (needing the assistance of another person) within  the last 12 months. You must also inform them if you or your medical team feels you are at high risk of developing hypoglycaemia.
• You develop impaired awareness of hypoglycaemia.
• You suffer severe hypoglycaemia while driving.
• An existing medical condition gets worse or you develop any other condition that may affect you driving safely

Please take the time to read the RSA Medical Fitness to Drive Guidelines (April 2014).

Driving requirements

If your diabetes is treated by insulin, you should check your glucose level within two hours of starting to drive and every two hours whilst you are driving. You must be safely pulled over and stopped when checking your glucose.

The RSA advise that if blood glucose is 5mmol/l or less you should take carbohydrate before driving. If it is less than 4mmol/l do not drive.

If you have poor hypo warning signs, or have frequent hypos, you should probably not be driving because of the risk to yourself and others. Discuss this with your diabetes healthcare team.

Drivers with diabetes treated with insulin or oral medications with potential for hypoglycaemia are advised by the RSA¹ to take the following precautions:

• You must  always carry your glucose meter and blood glucose strips with you. You must check your blood glucose  before driving and every two hours whilst you are driving.
• In each case if your blood glucose is 5.0mmol/l or less, or if you are worried that you may experience a hypo during the driving period, take a snack. If lt is less than 4.0mmol/l or you feel hypoglycaemic, do not drive.
• If hypoglycaemia develops while driving, stop the vehicle as soon as possible.
• You must switch off the engine, remove the keys from the ignition and move from the driver’s seat.
• You must not start driving until 45 minutes after blood glucose has returned to normal. It takes up to 45 minutes for the brain to recover fully.
• Always keep an emergency supply of fast-acting carbohydrate such as glucose tablets or sweets within easy reach in the vehicle.
• You should carry personal identification to show that you have diabetes in case of injury in a road traffic accident.
• Particular care should be taken during changes of insulin regimens, changes of lifestyle, exercise, travel and pregnancy.
• You must take regular meals, snacks and rest periods on long journeys. Always avoid.

What about insurance?

When you apply for insurance, you will need to tell your insurance company that you have diabetes.

However, you should not be penalised with a higher insurance premium because of your condition. All members of the Insurance Federation have now agreed that they will not load their premiums for people with diabetes.

Remember that failure to disclose any change in your health could invalidate your cover.

1. RSA - Sláinte agus Tiomáint - Medical Fitness To Drive Guidelines - (Group 1 and Group 2 Drivers)  April 2014