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Driving With Diabetes Guidelines

Diabetes And Driver's License Restrictions?

Diabetes And Driver's License Restrictions?

Have you ever wondered what the exact rules are, when it comes to diabetes and driver's license restrictions? We sure do, every time news stories pop up about unsafe driving involving PWDs (people with diabetes). We looked into this, and essentially learned that state laws differ; a comprehensive review by the American Diabetes Association (ADA) a few years ago shows that roughly half the states at the time had no required restrictions, while the other half had restrictions that were enacted into law. Questioning Myself Before we get into the specific laws, I'd like to share the fact that twice in my own life, I've gone low while driving and experienced dangerous scares that made me question whether I should even have a license and be on the road at all. The first was in my late teens not long after my high school graduation in 1997, long before I became an insulin pumper. I ended up swerving on the road and eventually getting pulled over by police in a parking lot. Thankfully, no accident occurred and no one was hurt. The second incident was about a decade ago, still before my CGM (continuous glucose monitoring) days. As a result of a fast-dropping blood sugar that didn't show itself with an in-the-moment fingerstick at work, I had a "sudden" hypo that led me wandering from my office in a daze into the parking garage. I apparently climbed into my my red Ford Escape and began driving towards home. I ended up in front of my subdivision in a ditch, after taking out a street sign with my car. Luckily (incredibly so!), no one was injured that time either. The latter inspired me to get a CGM, and ever since, I've not been behind the wheel without knowing where my blood sugars stand. While all of that motivated me to make some changes in the name of safety, I've still never b Continue reading >>

Guidelines For Diabetes And Private And Commercial Driving

Guidelines For Diabetes And Private And Commercial Driving

Diabetes & You > Healthy Living Resources > General Tips > Guidelines for Diabetes and Private and Commercial Driving Guidelines for Diabetes and Private and Commercial Driving Each province has its own rules regarding glucose (sugar) control and being able to drive. The following recommendations were published in the June 2003 issue of the Canadian Journal of Diabetes. You can also download and view the complete article entitled, Canadian Diabetes Associations Clinical Practice Guidelines for Diabetes and Private and Commercial Driving . Diabetes may affect driving performance due to chronic complications, which may impair sensory or motor function (diabetic eye disease (retinopathy) nerve damage (neuropathy), kidney disease (nephropathy), cardiovascular disease (CVD), peripheral vascular disease and stroke) and because of incidents of hypoglycemia. As the presence and extent of these factors vary from person to person, the Canadian Diabetes Association maintains the following position on Driving and Licensing: People with diabetes have the right to be assessed for a license to drive a motor vehicle on an individual basis in accordance with Canadian Diabetes Association guidelines for private and commercial driving. In assessing the suitability of people with diabetes to drive, medical evaluations are needed to document any complications and to assess blood glucose (sugar) control, including the frequency and severity of any hypoglycemic incidents. Hypoglycemia means low blood glucose (sugar) levels. Hypoglycemia can adversely affect driving performance and may contribute to some of the accidents that involve people with diabetes. The risk of severe hypoglycemia is greatest in people with type 1 diabetes who are using intensive insulin therapy (IIT), especially those Continue reading >>

Truck Drivers With Diabetes Dot Regulations

Truck Drivers With Diabetes Dot Regulations

The Department of Transportation (DOT) and the Federal Motor Carrier Safety Administration (FMCSA) adapted medical guidelines that diabetic truck drivers must meet. They are part of the requirements for obtaining an interstate Commercial Driver’s License (CDL). At one point in time, a truck driver with diabetes had to prove they have had diabetic episodes for three years to qualify for the diabetic exemption program. Since the diabetic exemption program was revised, this qualification no longer applies. Read below to find out what the new DOT regulations mean for prospective truck drivers with diabetes. Changing DOT regulations for diabetic truck drivers The first diabetic exemption program was established in 2003. It contained a long list of stipulations that made it hard for diabetic truck drivers to qualify for their CDL. This kept many capable truck drivers from employment with interstate trucking companies. One of the main DOT regulations hindering diabetic drivers from qualifying for the exemption program was the three-year rule. The three-year rule stated truck drivers with diabetes must have a record of driving for three years without a diabetic episode, and must have been on insulin for that time. It prevented nearly all potential drivers with diabetes from meeting the old DOT regulations. Between 2003 and 2005, only four exemptions were granted to diabetic truck drivers. On November 8, 2005, the FMCSA overturned some of the rules stated in the 2003 diabetic exemption program. The agency made vital changes, opening the road to more diabetic truck drivers. The FMCSA started accepting applications for the revised diabetic exemption program on September 22, 2005. Implementing changes in the DOT program for diabetic truck drivers The 2005 DOT regulations for the Continue reading >>

Driving And Type 2 Diabetes

Driving And Type 2 Diabetes

Having diabetes is not an issue for driving but if you are taking medications that leave you at risk of hypoglycaemia you must take extra precautions and you must inform the National Driver Licence Service. CHECK WITH YOUR PHARMACIST IF YOUR MEDICATIONS LEAVE YOU AT RISK OF HYPOGLYCEAMIA e.g. Insulin or Sulphonylureas such as Gliclazide (Diamicron®) or generic versions such as Diabrezide, Diaglyc, Diacronal MR, Diaclide MR, Gliclazide, Zycron MR.or the post prandial regular Nateglinide (Starlix®). If you are not at risk of hypoglycaemia you do not need to inform the National Driver Licence Service (NDLS). Medicine regimes change therefore remember to tell the NDLS if you start any of the medications that increase the risk of hypoglyceamia. Drivers at risk of 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 the first journey and every two hours whilst you are driving. • In each case if your blood glucose is 5.0mmol/l or less, take a snack. If it is less than 4.0mmol/l or you feel hypoglycaemic, do not drive and take appropriate action to correct glucose level. • 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, lucozade 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 tra Continue reading >>

Driving

Driving

The guidelines for diabetes and driving have recently been updated. This page and resources are currently under review. Please visit the Austroads website for more information. In March 2012, new medical standards came into effect for drivers of both private and commercial vehicles. The new standards are contained in the Austroads document Assessing Fitness to Drive 2012, which replaces the previous standards (Assessing Fitness to Drive 2003). The new standards include the following: Private vehicle drivers treated by glucose-lowering agents other than insulin may generally drive without licence restriction but should be required to have five-yearly reviews. In addition to the sections on hypoglycaemia, there is now a new section on hyperglycaemia for commercial drivers whose diabetes is treated by either insulin or other glucose lowering agents and for private drivers whose diabetes is treated with insulin. The new medical standards address ‘satisfactory control’ of diabetes and state that satisfactory control “will generally be defined as a glycated haemoglobin (HbA1c) level of less than 9.0% measured within the preceding three months”. The use of the term ‘generally’ is intended to allow medical practitioners to make their own clinical judgements on the ‘satisfactory control’ of diabetes on a case-by-case basis. ‘Satisfactory control’ of diabetes is required for a conditional licence to be considered by the driver licence authority. If you take medication for diabetes and you are a commercial driver, you must have an annual review by a specialist in endocrinology or diabetes to ensure you meet the specific criteria to hold a conditional licence. If you are a private driver and your diabetes is treated with insulin you must have a review at least e Continue reading >>

In The Spotlight: Driving With Type 1 Diabetes

In The Spotlight: Driving With Type 1 Diabetes

When a teen with type 1 diabetes is training to get his or her license, learning safe driving involves more than just pointers on parallel parking or correctly using turn signals. Managing blood sugar while behind the wheel is a serious safety issue for both the driver him- or herself and everyone else on the road. Is your teen ready to combine the responsibilities of good diabetes management with operating a motor vehicle? Your diabetes care team can help you with this question, as well as offer guidance on precautions to take. It’s a big step for parents to hand over the keys, but with type 1 in the mix, it can seem more like a giant leap. Check out these road-tested tips to help your child make the transition to the driver’s seat. A Different Kind of Driver’s Test Jaclyn A. Shepard, Psy.D., is a licensed pediatric psychologist and assistant professor at the University of Virginia School of Medicine. In addition to working with families and children coping with type 1 diabetes, she also helped develop the UVA-run Diabetes Driving study, an ongoing research project whose mission is to understand how drivers with type 1 can better prevent, detect and treat out-of-range blood sugar levels when driving. According to Shepard, feeling anxious about your teenager with diabetes learning to drive is normal, mainly because it goes with the territory of parenting a child who is rapidly becoming a young adult. “Parental worry is common as children gain independence and start spending more time away from home, which undoubtedly happens more when teens obtain their driver’s licenses,” she says. To help your child stay safe and keep worry and anxiety manageable, Shepard recommends parents begin communicating expectations and rules about driving and diabetes management be Continue reading >>

Driving And Diabetes

Driving And Diabetes

This site is intended for healthcare professionals drivers who have any form of diabetes treated with any insulin preparation must inform DVLA diabetic drivers are sent a detailed letter of explanation about driving and their licence by the DVLA see the menu item for more details on diabetic patients treated with insulin if their diabetes is treaded by tablets, diet or both drivers do not need to tell DVLA if their diabetes is treaded by tablets, diet or both and they are free of the diabetes related problems (given below, in appendix INF188/2 of the At a glance guidance) if diabetes is managed by tablets - which has a risk of inducing hypoglycaemia and includes sulphonylureas and glinides 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 at times relevant to driving to enable the detection of hypoglycaemia. if the above requirements and if free of the diabetes related problems (mentioned below), DVLA does not require notification alternatively if the information indicates that medical enquiries will need to be undertaken DVLA should be notified no episode of hypoglycaemia requiring the assistance of another person has occurred in the preceding 12 months regularly monitors blood glucose levels at least twice daily and at times relevant to driving must demonstrate and understanding of the risks of hypoglycaemia there are no other debarring complications of diabetes such as a visual field defect if meet the medical standards 1,2 or 3 year license will be issued the DVLA note for diabetes mellitus managed by tablets other than those managed by sulphonylureas and glinides or by non-insulin injectable medication if all the requiremen Continue reading >>

Driver Safety Information Diabetes Mellitus

Driver Safety Information Diabetes Mellitus

Driver Safety Information Diabetes Mellitus Diabetes mellitus is a chronic life-long metabolic disorder affecting approximately five to ten percent of the population. Diabetes can develop at any age. Insulin, a pancreatic hormone which maintains normal metabolism of carbohydrates, fats, and protein, regulates how the body uses and stores food for energy. Insulin is the key to diabetes. Lack of insulin affects the body's ability to properly use glucose. In diabetes, the body either stops producing insulin or cannot properly use the insulin it makes. The three types of diabetes mellitus are: Type I diabetes: Insulin Dependent Diabetes Mellitus (IDDM) Type I diabetes is diagnosed in ten percent of the people with diabetes mellitus. In Type I diabetes, there is a defect in the person's immune system that triggers the body to destroy its own insulin-producing cells. The onset of Type I diabetes usually occurs before age 40. People with Type I diabetes always require insulin injections to regulate their blood glucose in order to survive. Type II diabetes: Non-Insulin Dependent Diabetes Mellitus (NIDDM) Type II diabetes affects approximately sixty percent of people diagnosed with diabetes mellitus. Most people who acquire Type II diabetes are overweight and are over age 40. In Type II diabetes, the pancreas may produce an insufficient amount of insulin or the body may become resistant to insulin, causing it to be less effective or not to be used properly in maintaining metabolic control. Most people with Type II diabetes manage their blood glucose by diet and/or oral diabetes medicine. In some cases, insulin injections are also prescribed for Type II diabetes. Gestational Diabetes Mellitus (GDM) which develops during some pregnancies. Gestational Diabetes develops in approxim Continue reading >>

Diabetes Mellitus: Assessing Fitness To Drive

Diabetes Mellitus: Assessing Fitness To Drive

✘- Must not drive ! - May continue to drive subject to medical advice and/or notifying the DVLA ✓- May continue to drive and need not notify the DVLA Diabetes mellitus Insulin-treated drivers are sent a detailed letter from the DVLA explaining the licensing requirements and driving responsibilities. All drivers with diabetes must follow the information provided in ‘Information for drivers with diabetes’, which includes a notice of when they must contact the DVLA (see Appendix D). Insulin-treated diabetes Impaired awareness of hypoglycaemia The Secretary of State’s Honorary Medical Advisory Panel on Driving and Diabetes has defined impaired awareness of hypoglycaemia for Group 1 drivers as ‘an inability to detect the onset of hypoglycaemia because of total absence of warning symptoms’. Group 2 drivers must have full awareness of hypoglycaemia. ‘Severe’ is defined as hypoglycaemia requiring another person’s assistance. Group 1 Car and motorcycle Group 2 Bus and lorry ! - Must meet the criteria to drive and must notify the DVLA. All the following criteria must be met for the DVLA to license the person with insulin-treated diabetes for 1, 2 or 3 years: ■ adequate awareness of hypoglycaemia ■ no more than 1 episode of severe hypoglycaemia in the preceding 12 months ■ practises appropriate blood glucose monitoring as defined below ■ not regarded as a likely risk to the public while driving ■ meets the visual standards for acuity and visual field (see Chapter 6, visual disorders). ! - Must meet the criteria to drive and must notify the DVLA. All the following criteria must be met for the DVLA to license the person with insulin-treated diabetes for 1 year (with annual review as indicated last below): ■ full awareness of hypoglycaemia ■ no episo Continue reading >>

Driving & Your Rights

Driving & Your Rights

What is Diabetes Canada’s position on driving? People with diabetes have the right to be assessed for a license to drive a motor vehicle on an individual basis in accordance with Diabetes Canada guidelines for private and commercial driving. Read the Diabetes Canada's full position statement on driving and licensing, including background and rationale. What are Diabetes Canada's recommendations for private or commercial drivers? In October 2015, the Clinical and Scientific Section of the Diabetes Canada published Diabetes and Driving: 2015 Canadian Diabetes Association Updated Recommendations for Private and Commercial Drivers. I have been diagnosed with diabetes. Can I keep driving? Most likely. In consultation with your doctor, a decision will be made as to whether you are medically fit to drive. In assessing the suitability of people with diabetes to drive, medical evaluations document any complications and assess blood glucose (BG) control, including the frequency and severity of any hypoglycemic incidents. Diabetes and its complications can affect driving performance due to: Impaired sensory or motor function Diabetic eye disease (retinopathy) Nerve damage (neuropathy) Kidney disease (nephropathy) Cardiovascular disease (CVD) Peripheral vascular disease and stroke Incidents of hypoglycemia Motor vehicle licensing authorities can require licensed drivers to be examined for their medical fitness to drive. You should not have difficulty obtaining and maintaining an operator’s license if you: Properly manage your diabetes; Are able to recognize and treat the early symptoms of hypoglycemia; and Do not have complications that may interfere with your ability to drive. Do I have to report diabetes to the motor vehicle licensing authority? Yes. As a rule, anyone applyin Continue reading >>

Problems With The Eu Guidelines For Driving With Diabetes

Problems With The Eu Guidelines For Driving With Diabetes

Problems with the EU guidelines for driving with diabetes are emerging following a nurse winning back her driving license back after it was previously revoked by the DVLA. Helen Nichols, 26, has type 1 diabetes. After admitting two night-time events of hypoglycemia to the DVLA which required assistance from someone else, she lost her license. This is due to the 2011 EU guidelines which were implement following changes made to the EU law in August 2009. Under the new guidelines, these two hypos would be penalised, despite Helen’s control being otherwise exemplary. “I would be the first person to give up my driving licence if I was unsafe and constantly having hypos that I was unaware of because I mean no harm to others,” said Helen. Despite having no driving accidents while driving – she has managed her type 1 with insulin for 18 years – EU guidelines prevent the DVLA from distinguishing between conscious episodes of hypoglycemia and nocturnal hypoglycemia, which is much harder to manage. Helen originally published her frustration on the Diabetes.co.uk Forum, before setting up a petition. After losing her license in October 2014, her campaign eventually led to it being reinstated in April this year. “I hope that my case can be used by others now to demonstrate that other factors should be taken into account before a driving licence is suspended, unless there are concerns or any doubts from the patients’ GP or Consultant”. However, concerns from health care teams may not be accurate if a 2014 study is to be believed, which found fewer type 1 diabetes patients were reporting severe hypoglycemia to their health teams. Alongside the DVLA, doctors receive a form which, combined with your own information, formulates the basis of whether you will be allowed to d Continue reading >>

Commercial Truck Driving And Diabetes: Can You Become Truck Driver With Diabetes

Commercial Truck Driving And Diabetes: Can You Become Truck Driver With Diabetes

In this article we will explore what it takes to get a commercial driver’s license with diabetes, and how to get an insulin waiver for Type 1 and Type 2 persons who use insulin. We will look at requirements for Type 1 vs. Type 2 diabetes. We will look at insulin vs. non-insulin users. We will look at state vs. interstate CDL requirements. We will also look at the Federal Motor Carrier Safety Administration (FMCSA) diabetes waiver program, and how you can be evaluated to drive a commercial vehicle across state lines when you have diabetes and use insulin. Intrastate guidelines for CDL with diabetes If you want to work in the trucking industry only within your state, and you do not plan to cross any state lines, you can get approved to drive a commercial vehicle in your state. For drivers driving within state lines, you do not need to apply for the Federal Diabetes Exemption. Likewise, you would not need to apply for the Federal Diabetes Exemption if you do not use insulin. Whatever rules and regulations your state has for holding a CDL with diabetes is what you have to follow for intrastate or interstate trucking. It is important to know that most commercial driving will be considered interstate, not intrastate driving, even if you do not cross state lines. If you are carrying cargo or passengers to or from another state, this is also considered as interstate commercial driving. For information on intrastate commercial driving, check with your home state for CDL requirements and see if they are applicable to you. They vary from state to state, with each state having its own regulations. You can look up the laws governing your state by visiting this page at the American Diabetes Association website, You can type your home state in the search for laws and requirements fo Continue reading >>

Guideline For Driving With Diabetes

Guideline For Driving With Diabetes

VIEW PDF Driving safely is more than just watching where you are going; it’s also watching where your blood sugar is going. People taking insulin are at risk for low blood sugar reactions. Even mild hypoglycemia (60-70 mg/dl) may be enough to interfere with your judgement and driving. Create a Driving Contract for Your Teen with Diabetes Driving Contract Points Agree to test blood glucose at least 4 times a day before meals and bedtime. Agree to contact the office for insulin adjustments if you are having patterns of hypoglycemia or hyperglycemia. Come to your diabetes appointments as recommended by your endocrinologist. Before getting behind the wheel, check your blood sugar. If it is less than 100, take some carbohydrate. Don’t start the car until your blood sugar is at least 100. Check your blood glucose every hour while on the road. Keep your meter and glucose tablets with you at all times, and always have glucose tablets available in the car. If you feel low while driving, you must pull over and treat yourself until you are over 100. Carbohydrate sources must be easily accessible. If you will be on the road for a while (vacations, etc), think ahead and have food available in case you get stuck in traffic or don’t have access to food on the road. Wear a medical alert bracelet or neck charm. If you become hypoglycemic despite your precautions, erratic driving may cause an accident or bring you to the attention of the police. Without identification, an officer or medical personnel may assume you are drunk or on drugs. A wallet card may not be found until it’s too late. No one advocates taking away the licenses of people with diabetes, but driving is a responsibility and a privilege, not a right. You agree that we reserve the right to hold off on filling out DM Continue reading >>

Diabetes And Driving

Diabetes And Driving

You can be fined up to £1,000 if you don’t tell DVLA about a medical condition that affects your driving. You may be prosecuted if you’re involved in an accident as a result. Check with your nurse or doctor if you don’t know what type of medication you’re on. Read leaflet INF188/2 for more information about driving a car or motorbike with diabetes. Diabetes treated by insulin Car or motorbike licence You must tell DVLA if your diabetes is treated with insulin. You can also fill in form DIAB1 and send it to DVLA. The address is on the form. Bus, coach or lorry licence You must tell DVLA if your diabetes is treated with insulin. Fill in form VDIAB1I and send it to DVLA. The address is on the form. Read leaflet INS186 if you want to apply for vocational entitlement to drive larger vehicles (C1, C1E, D1, DIE, C, CE, D or DE). Diabetes treated by tablets or non-insulin injections Car or motorbike licence Check with your doctor or nurse to find out if your treatment means you need to tell DVLA. If you do need to tell DVLA, fill in form DIAB1 and send it to the address on the form. Bus, coach or lorry licence You must tell DVLA if your diabetes is treated by tablets or non-insulin injections. You must fill in: form VDIAB1SG if your diabetes is treated by sulphonylurea or glinide tablets form VDIAB1GEN if your diabetes is treated by any other tablets or non-insulin injections Send the form to DVLA. The address is on the form. Diabetes treated by diet Car or motorbike licence You don’t need to tell DVLA. Bus, coach or lorry licence You don’t need to tell DVLA. Continue reading >>

Driving And Diabetes: Problems, Licensing Restrictions And Recommendations For Safe Driving

Driving And Diabetes: Problems, Licensing Restrictions And Recommendations For Safe Driving

Abstract Driving is a complex process that places considerable demands on cognitive and physical functions. Many complications of diabetes can potentially impair driving performance, including those affecting vision, cognition and peripheral neural function. Hypoglycemia is a common side-effect of insulin and sulfonylurea therapy, impairing many cognitive domains necessary for safe driving performance. Driving simulator studies have demonstrated how driving performance deteriorates during hypoglycemia. Driving behavior that may predispose to hypoglycemia while driving is examined. Studies examining the risk of road traffic accidents in people with insulin-treated diabetes have produced conflicting results, but the potential risk of hypoglycemia-related road traffic accidents has led to many countries imposing restrictions on the type and duration of driving licenses that can be issued to drivers with diabetes. Guidance that promotes safe driving practice has been provided for drivers with insulin-treated diabetes, which is the group principally addressed in this review. Keywords DiabetesType 1 diabetesType 2 diabetesInsulin therapyHypoglycemiaAutomobile drivingDriving performanceDriving licenseRoad traffic accidentMotor vehicle accident Introduction Driving has important business and recreational roles for transport in most countries, allowing people to travel to and from work, pursue their employment, and undertake multiple social and domestic activities. Most people regard driving to be a fundamental part of daily life; especially those with limited access to public transport [1]. Safe driving requires complex psychomotor skills, rapid information processing, vigilance and sound judgment [2]. Driving is classified as a light physical activity [3] but has considerable Continue reading >>

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