Diabetes Mellitus
Failure to meet these standards or the presence of any progressive neurological disorder requires the applicant or license holder to inform the Driving Licensing Authority unless stated otherwise in the text.
Medical Fitness to Drive Guidelines
| Diabetes Mellitus | Group 1 — Car, M/Cycle |
Insulin-TreatedSee Appendix to this chapter for advice to drivers. |
|
Temporary Insulin TreatmentE.g. Post-Myocardial Infarction, participants in Oral/Inhaled Insulin Trials. |
Impaired awareness of hypoglycaemia is defined as, ‘an inability to detect the onset of hypoglycaemia because of a total absence of warning symptoms’. If meets the medical standard a 1 or 3 year licence will be issued. Provided they are under medical supervision and have not been advised by their doctor that they are at risk of disabling hypoglycaemia, need not notify Driving Licensing Authority. If experiencing disabling hypoglycaemia, Driver must notify Driving Licensing Authority.Notify Driving Licensing Authority if treatment continues for more than 3 months or for more than 3 months after delivery for gestational diabetes. |
Managed by tablets which carry a risk of Inducing Hypoglycaemia. This includes Sulphonylureas and GlinidesSee Appendix to this chapter for advice to drivers. |
Must not have had more than one episode of hypoglycaemia requiring the assistance of another person within the preceding 12 months. It may be appropriate to monitor blood glucose regularly and driver should monitor blood glucose at times relevant to driving to enable the detection of hypoglycaemia. Must be under regular medical review. If however there has been a hypoglycaemic event in the preceding 12 months,
Driver must notify Driving Licensing Authority. |
Managed by tablets other than those on the previous page or by non-insulin injectable medicationSee Appendix to this chapter for advice to drivers. |
Need not notify Driving Licensing Authority unless develop associated conditions which are relevant to safe driving. E.g. Diabetic eye problems affecting visual acuity or visual field or if insulin required. |
Managed by diet alone |
Need not notify Driving Licensing Authority unless develop associated conditions which are relevant to safe driving. E.g. Diabetic eye problems affecting visual acuity or visual field or if insulin required. |
Impaired awareness of Hypoglycaemia |
If confirmed, driving must stop. Driving may resume provided reports show awareness of hypoglycaemia has been regained, confirmed by consultant/GP report. |
Eyesight Complications (affecting visual acuity or fields) |
See section: Visual Disorders Chapter 7. |
Renal Disorders |
See section: Renal Disorders Chapter 8. |
Limb DisabilityE.g. Peripheral Neuropathy |
See section: Disabled Drivers Chapter 10. |
Appendix
Group 1
A guide for drivers with insulin treated diabetes or oral medications with potential for hypoglycaemia (such as sulfonylureas and glinides) who wish to apply for Group 1 licenses.
Drivers who have any form of diabetes treated with any insulin preparation or oral medications with potential for hypoglycaemia (such as sulfonylureas and glinides) must inform the Driving Licensing Authority, unless it is temporary insulin treatment during pregnancy for a period of less than 3 months — discuss with your obstetrician or diabetes specialist if this is the case.
Hypoglycaemia
Hypoglycaemia (also known as a hypo) is the medical term for a low blood glucose (sugar) level.
Severe Hypoglycaemia
Severe hypoglycaemia means the assistance of another person is required. The risk of hypoglycaemia is the main danger to safe driving and this risk increases the longer you are on insulin treatment. This may endanger your own life as well as that of other road users. Many of the accidents caused by hypoglycaemia are because drivers carry on driving even though they get warning symptoms of hypoglycaemia. If you get warning symptoms of hypoglycaemia whilst driving, you must always stop as soon as safely possible — do not ignore the warning symptoms.
Early symptoms of hypoglycaemia include:
- Sweating, shakiness or trembling, feeling hungry, fast pulse or palpitations, anxiety, tingling lips.
If you don't treat this it may result in more severe symptoms such as:
- Slurred speech, difficulty concentrating, confusion, disorderly or irrational behavior, which may be mistaken for drunkenness. If left untreated, this may lead to unconsciousness.
Drivers with diabetes treated with insulin or oral medications with potential for hypoglycaemia are advised 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 5.0 mmol/l or less, or if you are worried that you may experience a hypo during the driving period, take a snack. If it is less than 4.0 mmol/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.
You must inform the Licensing Authority if:
- You suffer more than one episode of severe hypoglycaemia (needing the assistance of another person) within the last 12 months. You must also tell us if you or your medical team feels you are at high risk of developing hypoglycaemia.
- You develop impaired awareness of hypoglycaemia (difficulty in recognising the warning symptoms of low blood sugar).
- You suffer severe hypoglycaemia while driving.
- An existing medical condition gets worse or you develop any other condition that may affect you driving safely.
