Driving with diabetes still has its challenges. But the array of technology features at the fingertips of the modern driver has certainly eased that burden for each and every one of us, writes Owain Williams, who shares his experience. He was diagnosed with type 1 diabetes when he was four and is a frequent traveller in the UK and abroad.
We only need cast our mind back to remember the historic challenges for diabetic drivers. Getting stuck in a car park due to a symptomless hypo having already paid for the exit ticket — familiar? Or the slight panic in the faces of our first dates as they opened the ‘wrong’ sunglasses case to find a ‘stash’ of spare syringes?
Forewarned is forearmed. As diabetics, we’ve always been indebted to the humble wine gum, however scandalously overpriced they might be.
Our gelatinous saviour, ever-present for that (rare?) “I’ve-forgotten-or-run-out-of-my-dextrose” emergency. A certain sense of smugness we feel, at least until our searching hands descend into the open packet and run the merry finger-dance around all corners of that emptied receptacle, with fingers pausing in remote sensory disbelief.
The challenge of not glaring at the sticky faces of wide-eyed children with a cheeky grin or the eyes-averted in-laws who hoovered up every last sweet, while I left the car for a pee or to fill up with fuel. Every last blighter! Aside from the part-chewed radioactive green ones. “Hello darling, we’re going to be a touch late for dinner.”
Familiar with motorway monotony though, and the gum guzzlers, I am prone to stocking up: sugar tablets in my trousers, another in my coat, Lucozade in my laptop bag, backups in the boot, and a supply of spare dextrose in my wife’s handbag! Once a boy scout, ever a boy scout!
"Even as a diabetic passenger these come in handy when hitting a hypo as your driving companion winds through hilly forest and mountain roads, a sure-fire cue to inevitable motion sickness — you too?"
Technology has improved our journey without a shadow of a doubt. I don’t mean the A3 spiral-bound road atlases of yesteryear, replaced by myriad sat nav systems.
Remember trying to pick up objects that are so flat they almost qualify as two-dimensional? The blood strips and the paper covers from screw-on needles that appear to be fastened to the base of your cupholder and door pockets, however much you try to tuck your nail under them. Thank God for vacuums with extendible hoses.
Who remembers the glovebox, central console and door pockets full of Dextrosol, Hypostop, needles, lancets and spare batteries, with their characteristic ricochet of rattles at every pothole, rumble strip and speed bump? Thank God for continuous glucose monitors (CGMs) and the linings on car pockets!
Thank God for insulin pumps
Then there’s the uncanny irony, that no matter where you park in a motorway services area, the location you choose is never private. Yes the abdomen is trivial to cover.
But the brave (sometimes necessary) decision to drop your trousers or raise a skirt to inject in the privacy of your vehicle can certainly spur some surprised, confused and eye-goggling looks from those who venture too close to your vehicle of choice. Thank God for insulin pumps.
Pumps can helpfully avoid other awkward social situations too. I still remember the dubious and distrustful looks of scorn and contempt from onlookers on my return to the car at roadside services some years back. I was puzzled until my wife explained my son’s preceding situation report, apparently delivered at unfiltered ‘child volume’ not only to my wife but the neighbouring travellers: "Mummy, daddy’s high and in the toilet having another injection".
And of course, squeezing your hand into the narrow gap between the chair and centre console or having to get on hands and knees in the back of the car to retrieve a lost needle cap, your finger pricker or your last blood strip from your only tub of strips – oh how CGM and pumps have saved us!
The pump has even helped reduce the massively frustrating instances of leaving insulin at home and having to drive all the way, 100 miles or more to complete the loop back to ‘GO’ in true Monopoly style. No £200 for this unplanned return to your point of origin though.
I can vouch for the fact that the alternative fate, attempting to find a nearby open health centre and duty pharmacy at a weekend is never an ideal way to ingratiate your new love with your home town or romantic holiday destination. Oh, if any of you found my NovoPen in the seat pocket of the 17:47 to London Euston in 2013, fear not, I did manage to obtain an alternative and can clarify retail pricing.
Healthier snacks on the move
It’s not technology alone that has eased our journeys: healthy-eating awareness campaigns and ever-growing consumer demand are gradually revolutionising our drive-through cafés, service stations and even some drive-in cinemas.
The historic bias toward sugary and “Hello Dentist” high-GI snacks and the lower-GI but poor prognosis fatty snacks are steadily being supplemented by a growing availability of fruit, veg and wholegrain starchy carbs.
We diabetics know that alongside exercise, healthy eating is fundamental to long-term health, good HbA1C and reducing the risk of long-term diabetes complications. But the retailers being driven to revamp their ranges are really helping us maintain stable glucose readings in our vehicles. Particularly helpful when we join the eight-hour ritualistic queue to Devon or Dundee, and for the patient lorry drivers whose trails extend across the length and breadth of Britain.
However healthy our plate, fate loves a curveball. Delayed glucose absorption from a low-GI snack? The challenge does arise when devoid of glucose on our person and in a hypoglycaemic state, we return on foot to our car, bike, taxi or lorry. Stumbling along to retrieve our Lucozade, Dextrosol, juice, even our green wine gums(!).
Now, keep me honest? Am I the only diabetic who is disorganised in their personal life? Is it only me that is familiar with the benefit of the car when rushing to the chemist to pick up medications (often ordered two weeks earlier) only when you realise you’ve almost run out?
If the supply chain shortages of the last 18 months have taught me anything, it is that I really need to keep my local reserve of diabetic products slightly higher! But looking back over a number of last-minute dashes, thank goodness for the car itself!
But maybe before we reach for our keys, could we walk instead, or mount our bikes and scooters? With endorphins aplenty, reduced stress and a clear head, even a short bout of exercise can help. Regardless of the proven psychological and physical benefits, what better opportunity to shock the neighbours with my dazzling white legs and knobbly knees?!
If the engineering and clinical trials of glucose-sensitive insulin are to prove successful, the challenges of the diabetic driving experience will forever be transformed. Until then, regular testing and CGM and Flash 2 alarms, not delaying meals and taking regular breaks can help keep us safe at the wheel and in the passenger seat.
The views and opinions expressed in the ‘views’ section of this website belong solely to the authors of each article. These views and opinions do not necessarily represent those of Diabetes UK as a charity or any of its staff members.
Owain Williams is pictured with his son. He tweets @expattaff.