Driving and diabetes

"When you have diabetes and your treatment puts you at risk of a “hypo”, test your blood sugar before you start your car or risk prosecution or worse. Recent legal cases highlight the need to be vigilant"

Every time you drive, it is your duty to ensure that you are safely able to control the vehicle. This requires consideration of your general health, your vision and consideration of any substance that could impair your concentration.

In normal circumstances having diabetes is unlikely to impact on your ability to hold a driving licence. However, diabetes complications or treatment of diabetes by insulin and/or some medications may impair your ability to drive. So you need to exercise caution at all times.

Licensing Authority
If your diabetes is treated with insulin or tablets, by law you must inform the Driver and Vehicle Licensing Agency (DVLA through your local motor tax office) as soon as you can after the diagnosis. You should also inform them if you have had diabetes for some time and are applying for a licence, maybe for the first time. If you are being treated by diet alone for your diabetes, you do not need to inform the DVLA. However, if you begin to take tablets or insulin, you must inform them of this.

Medical and visual checks
Holding a driving licence is not a right but a privilege and is subject to the usual medical and visual checks. The visual requirement is standard regardless to you having diabetes or not. You must have vision either unaided or corrected to enable you to read the number plate of the car 18 feet ahead of you. Remember if this is corrected vision, you must wear your prescription glasses every time you drive. Medical certification is necessary for renewal of every driving license irrespective of the type of diabetes or the method of treatment. For many applicants, their general practitioner, who will determine how long the report is valid for, may complete the medical report. Usually, medical certificate is from one year to a maximum of ten years but depends on age and general medical condition. In the case of person requiring insulin, it is usually the diabetes consultant who completes this report.

Legal cases
There have been many cases where people with diabetes were involved in road traffic accidents and have been reprimanded by heavy fines for failing to follow the safe driving guidelines regardless to the additional prosecution for the accident.

Henry is a middle aged man with diabetes who takes a small dose of daily insulin with supplementary insulin on demand. Henry drove through red traffic lights and hit the side of a car going in the opposite direction. Henry was unhurt but the occupants of the car he crashed into were not so lucky and were taken to hospital with serious injuries. The emergency service crew examined Henry and found him to be alert, orientated and unhurt. He was arrested and brought to the local station. On arrival he asked for some food explaining that he had missed lunch and this was important to him as he had diabetes. In the presence of a guard, he checked his blood sugar and it was found to be 1.3 mmol/L. The guard having diabetes himself knew the significance of the low blood sugar and summoned assistance. It was apparent that Henry had a low blood sugar which caused him to drive through a red light, something he would not normally do. The general opinion was that he would have to be charged with dangerous driving but with evidence of a low blood sugar would get away without a harsh conviction.

However, when the case came before the judge, he took a very serious view and “drew the book” at Henry. The judge sought evidence (memory in meter) that Henry had checked his blood sugar prior to driving his car and when this was not available asked Henry how he normally got to work. On hearing that he drove daily the judge requested proof that Henry tested his blood sugar prior to driving any day. Henry was unable to show any kind of daily pattern of testing prior to going to or returning from work. Therefore, the judge fined him heavily and disqualified him from driving. A hard lesson for Henry, but one that all should learn from.

Insurance Cover
On diagnosis of diabetes, all drivers must inform their insurance company or risk non-coverage in the event of an accident. Each company differs in respect to the supporting medical documentation they require.

The Diabetes Federation of Ireland has a motor insurance scheme in place with Allianz which is facilitated through our insurance brokers, ERM Financial Services (01 8454361). Under this scheme, our members can apply for motor insurance cover where they are asked 2 oral questions, one in relation to being a member of the Federation and the other in relation to having had any serious hypos in the last 5 years. Your answer to these questions will determine whether Allianz require supporting documentation or not for this scheme. Through this scheme there is a 5% discount on normal standard ratings.

Many people with diabetes apply directly to Allianz and other companies for motor insurance cover. In Ireland, it is normal standard practice for these companies to ask clients to complete a questionnaire. The information you declare determines whether further supporting medical documentation is required. In most cases, further information is not required and the client is saved the hassle and cost of going to their GP, which was not the case in the recent past when all people with diabetes had to provide supporting medical information from their GP regarding their fitness to drive.

If you do not wish to complete this type of questionnaire, you can get motor insurance cover directly from Eagle Star whose only requirement is that you have a full Irish driving licence. As stated every individual must provide written medical confirmation from their doctor on their fitness to drive in order to get a full Irish driving licence. Eagle Star use the premise that if the Driving and Vehicle Licencing Authority issue you a driving licence then you are fit to drive and they do not seek any further clarification of that.

Simple precautions help to ensure safe driving.
• Any journey should be planned with special attention to when hypoglycaemia may occur.
• Relaxation of glycaemic control may lessen the likelihood of such episodes. When undertaking long journeys, it may be more appropriate to aim for mid rather than lower limits of target blood sugar levels.
• Levels should be monitored before and during the journey. It is essential that quick acting carbohydrates be near at hand throughout the journey. A small juice drink can be carried in the glove compartment for such emergencies.
• One should always carry identification relating to diabetes management in the case of involvement in a road traffic accident.
• On long journeys, stop regularly to snack and take a short walk. Needless to say, alcohol should always be avoided.

In the event of experiencing the warning signs of a hypoglycaemia, pull in immediately and turn off the ignition. Leave the driving seat, as a charge could be made of driving under the influence (insulin is classified as a drug) even if the car is stationary. Confirm level of hypoglycaemia and take glucose in readily available form. Do not resume driving until after taking a snack. It is recommended not to drive for 45 minutes after a hypoglycaemic event.

APP/KOL/AC 2008–02–05

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Last updated: May 2008