Some people develop diabetes-related complications. Examples of those that are important for driving are problems with eyesight or loss of body sensation, especially in the legs or feet.
Problems with eyesight (retinopathy)
Obviously it is important that you are able to see clearly if you are going to drive. This includes not only distance vision but also your field of vision (what you can see to either side when looking straight ahead). Your field of vision must cover at least 120° along the horizontal to be acceptable and the extension should be at least 50° left and right. In addition, your binocular field must have no significant defect. There are various tests that an ophthalmologist can carry out to test these factors.
If you fail a field of vision test your licence may be revoked, although you can appeal against this decision. To appeal you must show that your field of vision meets the required standard so you must pass another field of vision test. Some people do better on different types of field of vision tests. The DVLA/DVA will accept the results of several approved tests. You should therefore discuss the test with your doctor or ophthalmologist.
Diabetic retinopathy is caused by damage to blood vessels of the retina (the ‘seeing’ part at the back of the eye) and is a complication that can affect anyone who has diabetes. Generally, retinopathy has no obvious symptoms, so you may not know you have it until it is well advanced. That’s why an eye examination every year, to check for retinopathy is essential for everyone with diabetes.
Having retinopathy does not necessarily mean that you have to give up driving. It is important for you to find out what degree of retinopathy you have from your healthcare team. You must inform the DVLA/DVA if you have had laser treatment or injections to both eyes for retinopathy or to the remaining eye if monocular. If you have had laser treatment you may be asked to have a vision of field or night vision test. You must also inform them if you have any other conditions that affect both eyes or the remaining eye if you have sight in only one eye.
Problems with circulation/sensation (neuropathy)
The law requires you to inform the DVLA/DVA if you develop peripheral neuropathy (problems with the circulation or sensation in the legs or feet) that may cause difficulty with the safe use of foot pedals. This may be overcome by restricting driving to automatic vehicles or adaptations such as hand operated accelerator/brake. This must be noted in the licence.
Other diabetic complications
If you have nephropathy (kidney damage) and you require dialysis there is no restriction on holding a 'till 70' licence. However, if you develop significant symptoms that affect your ability to drive, such as fainting and giddiness, your licence may be revoked.
Gestational diabetes
If you develop gestational diabetes and need to commence insulin treatment you should notify the DVLA/DVA immediately. You will normally be allowed to continue with your current driving licence but are recommended to stop driving if your control is unstable and especially if you do not have good warning signs of impending hypoglycaemia.
Transplants
Whole pancreas transplant or pancreatic islet cell transplant
If you have undergone whole pancreas transplant or pancreatic cell transplant whether or not you are still taking insulin, you will need to inform the DVLA and DVA, who will issue you with a short term three-year licence, free of charge. After this time, you will be medically reviewed on a three-yearly basis. This is due to the current graft failure rate.
Reviewed May 2012