Guest post by David Mapletoft Diabetes Educator
Recently a driver needed to be subdued with a taser after hitting several cars in a parking lot and refusing a policeman’s instructions to stop. The driver, who had diabetes, appeared to have been suffering a hypoglycemic episode. Fortunately, the officer recognised this. The man was given emergency treatment, stabilised, and taken to the hospital. He was not charged with breaking the law.
If you develop diabetes you must inform the Driver Licensing Authorities in your state or territory. In most cases if you manage your diabetes by insulin you will require a medical certificate every two years and if you manage it by tablet every five years. If you control your diabetes by diet and exercise alone you are still required to inform them. If you are required to notify the authorities but don’t, you could be charged with driving offences if you have a driving accident.
If you develop diabetes it is also advisable to inform your motor vehicle insurer. If you don’t report your diabetes to your motor vehicle insurance company you may have problems with insurance claims.
Do you know the law in your state?
Have you advised your road traffic authority about your diabetes?
Hypoglycaemic impairment is not the only hazard that can complicate driving. Other potential complications of Type 1 diabetes and Type 2 diabetes include vision impairment and neuropathy leading to loss of feeling in the feet and hands, for example.
Why such a state by state variance? In Australia the issuance of driver licenses, rules of the road, and regulation of conduct by drivers is reserved to the states. Contrary to common perception, there is no such thing as a federal driver’s license.
Under the act, there is a requirement for commercial drivers to pass a physical exam, and regulations to govern how drivers use medication under professional supervision. There is a “diabetes” endorsement available on a driver’s fitness certificate to accommodate users of insulin and oral medication.
Sometimes, diabetes driving laws have unintended consequences. Denmark, for example, has a 2012 diabetes reporting and licensing law which has backfired. According to a 2014 study reported by the Driving Licence Committee of the European Union, drivers in Denmark have blatantly disobeyed a requirement that they report instances of hypoglycemic events to their care providers, who can then report the incidents to licensing authorities. Rather than risk loss or restriction of license, the study found that about a million Danes a year lie to their doctors about their lows.
Risks of not informing the motoring authority: your insurer won’t cover any damages.
You may face a gaol term if anyone is seriously injured.
Driving laws for non-commercial drivers concerning diabetes and other medical conditions run the gambit:
- Some require the driver to disclose a condition at the time of applying for a license or renewal
- Some have diabetes-specific restrictions, usually only addressing Type 1 diabetes with insulin therapy
- Some states require a periodic physical exam with accompanying physician’s certification for license renewal
- Some require a physician to report a condition after its discovery
- Some allow anyone, including a family member or an acquaintance, to report on someone with a limiting medical condition who is operating a motor vehicle
In a January 2012 report, the American Diabetes Association took the position that greater education was needed to ensure the safety of drivers with diabetes:
“The diagnosis of diabetes is not sufficient to make any judgements about individual driver capacity … Perhaps the most important aspect of encouraging people with diabetes to be safe drivers is…to provide education about driving with diabetes and potential risks associated with patients’ treatment regimens.”
The position paper also offered four key points of advice on self-care behind the wheel:
- Always carry a blood glucose meter and appropriate snacks, including a quick-acting source of sugar (such as juice, non-diet soft drink , soft lollies, or dextrose tablets) as well as snacks with complex carbohydrate, fat, and protein (e.g., biscuits) in the vehicle
- Never begin an extended drive with blood glucoses at 70–90 mg/dL or lower without prophylactic carbohydrate consumption to avoid a fall in blood glucose during the drive
- Stop the vehicle as soon as you experience any of the symptoms of hypoglycemia, and measure and treat the low
- Do not resume driving until blood glucose levels, and function, have recovered.
The best thing about this advice is that not only is it grounded in best medical practice, it’s all about your safety and the safety of other road users.
David Mapletoft Diabetes Educator