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Driving and diabetes – what healthcare professionals should know

Changes to the medical standards for driving licences for people with diabetes came into effect in 2011, but confusion still exists about these standards. Healthcare professionals play an important role in ensuring that their patients understand what is required to retain their driving licences and keep them safely on the road.

Key messages for patients – diabetes and driving

  • You do not need to tell the DVLA if you are a Group 1 (car or motorbike) driver and you control your diabetes by diet or tablets, but you do if you are on insulin.
  • If you are on any non-insulin medication for diabetes you do not need to notify the DVLA unless you had two episodes of severe hypoglycaemia within the last 12 months or develop impaired awareness of hypoglycaemia. This is most likely to happen on a sulphonylurea or glinide.
  • If you have insulin-treated diabetes, you should test blood glucose before driving. Do not drive if your blood glucose is below 4 mmol/l. You should re-test blood glucose every two hours on a long journey.
  • If you have a hypoglycaemic episode while driving, stop the vehicle as soon as possible. Switch off the engine, remove the keys from the ignition and move from the driver's seat. Take some fast-acting carbohydrate, such as glucose tablets or sweets, and some form of longer-acting carbohydrate. Do not start driving until 45 minutes after blood glucose has returned to normal.
  • A severe hypoglycaemic attack is one where you require (rather than just receive) the assistance of another person, ie you cannot help yourself.
  • Having hypos (even severe ones) does not mean a lifetime ban. You may still be able to drive after having a hypo attack.

Group 2 licences (vehicles over 7.5 tonnes)

  • You must tell the DVLA if you have any form of diabetes for which you take medication and are a Group 2 (bus and lorry / vehicles over 7.5 tonnes) driver.
  • If you have insulin-treated diabetes you will need to provide three months of continuous meter readings every time you apply for a Group 2 licence. You should be doing this regularly anyway, not just when coming up for a medical.

The reality of the risk

People with diabetes are no less safe than any other group in the population. A review of the evidence for the European Working Group on Diabetes and Driving (1) found that any differences in risk were small compared with the differences in risk seen in the general population. Those of concern are a small group of people who are experiencing recurrent severe hypoglycaemia or who have lost awareness of hypoglycaemia (1).

The new licensing standards aim to identify this group of people and to ensure that they are not driving while they may be at risk. The DVLA stresses that it wants to give people licences and will only revoke them when there is good reason to do so.

More guidance for healthcare professionals

The DVLA is also planning to provide further advice to GPs, and other healthcare professionals, about how they should complete DVLA forms, eg they want to know about a severe hypo and impaired awareness of hypoglycaemia, not just the blood glucose readings. Other relevant medical conditions, such as a visual field defect, should also be reported.

Further information

References

  1. Berne C et al (2006). Diabetes and Driving in Europe. A report of the Second European Working Group on Diabetes and Driving, an advisory board to the Driving Licence Committee of the European Union.
  2. Joule N (2013). Diabetes and driving: getting it right. Diabetes Update. Summer 2013; 28–30.
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