Diabetes - A group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger).
Type 1 DM - Results from the body's failure to produce insulin, and currently requires the person to inject insulin or wear an insulin pump. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes".
Type 2 DM - Results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. This form was previously referred to as non insulin-dependent diabetes mellitus (NIDDM) or "adult-onset diabetes". Approximately 90% of all cases of diabetes worldwide are of this type.
When people with diabetes are compared with those who do not have diabetes, analysis has shown that the relative risk of motor vehicle accidents are increased by 12-19%. In comparison, the rate for sleep apnea is 2.4% and attention deficit disorder is 4.4%. Research suggests that people who are at risk for hypoglycemia-related motor vehicle accidents might have some characteristics in common, to include a history of severe hypoglycemia or hypoglycemia-related driving accidents. Studies have also demonstrated that people with a history of hypoglycemia-related driving accidents have counter-regulatory responses to hypoglycemia and experience greater cognitive impairments during moderate hypoglycemia.
Driving and Diabetes
For the majority of people who drive, doing so represents freedom, control and competence. Driving a vehicle enables most people to go to the place they want or need to. For many people, driving is economically important because they drive as a part of their job, or they drive to get to and from their place of employment.
Driving really is a complex skill. A person's ability to drive safely might be affected by changes in their physical, mental, or emotional condition. Diabetes can make a person's blood sugar levels too low or high. Due to low or high blood sugar levels, a person may experience:
In the long-term, diabetes may lead to issues that affect a person's driving abilities. Diabetes might cause nerve damage in a person's feet, legs, hands, or eyes. In some instances, diabetes may cause blindness or lead to an amputation. People with diabetes are able to drive unless they are limited by certain complications such as severe low blood glucose levels or vision issues. People who experience diabetes-related complications need to work closely with their health care team to find out if diabetes affects their ability to drive a vehicle. If it does, there are actions that can be taken to continue driving safely.
Ensuring that You Drive Safely with Diabetes
Some oral medications and insulin can cause a person's blood glucose levels to become very low and they may experience hypoglycemia. Do not drive if your blood glucose level is too low, you may not be able to make good choices, concentrate on driving or control of your vehicle. Your health care team can help you to determine when you should check your blood glucose level prior to driving, as well as how often you should check it while you are driving.
It is important for drivers with diabetes to always carry their blood glucose meter with them. They should always carry plenty of snacks as well, to include a quick-acting source of glucose. It is important to pull over as soon as you feel any of the signs of low blood glucose and check your blood sugar level.
If your glucose level is low, eat a snack that contains a fast-acting sugar like juice, soda containing sugar, glucose tablets, or hard candy; then wait for 15 minutes and check your blood sugar level again. After your glucose level has risen, eat something more substantial that contains protein. Do not drive again until your blood glucose level has notably improved.
The majority of people with diabetes experience warning signs that their glucose level is low. If you experience hypoglycemia without some kind of warning you should not drive. Speak with your health care team about how glycemic awareness training may help you to be more aware of the beginning stages of hypoglycemia.
In some situations, high blood glucose levels or, 'hyperglycemia,' can also affect a person's driving abilities. Speak with your health care team if you have a history of very high glucose levels to figure out at what point high glucose levels may affect your ability to drive safely and what you can do about it.
If you experience long-term complications of diabetes such as sensation issues or vision problems, or if you have had an amputation, your health care team can refer you to a driving specialist. The specialist can give you on and off road tests to find out if and how your diabetes is affecting your driving abilities. The specialist may also offer you training to improve your driving skills and keep you and others safe on the road.
If You Have to Give Up Driving
Even if you have to cut back on how much you drive due to diabetes, or give it up entirely, you can still keep your independence. Doing so may take some advance planning on your part, but the planning will help you to get to the places you need to go and visit the people you want to. Some of the things you may consider if this is what you need to do include:
Evaluation of the research that is available regarding diabetes and driving is difficult. Most older studies have either found no association between diabetes and traffic accidents, or a small and often times not statistically significant increase in the relative risk. More recent research in the United States indicates a clear trend - frequently statistically significant, toward an increased risk of road accidents in drivers with diabetes.
The increase of the risk in some studies was only found in specific subgroups of people with diabetes, not consistent throughout different studies. Overall, the studies available indicate that road traffic accidents caused directly by diabetes appear to be fairly rare occurrences. It is important to note; however, that hypoglycemia during driving does happen and may cause traffic accidents.
Resources and Citations:
Driving and Diabetes: When is it safe
Driving is a skill that so many Americans take for granted. But diabetes patients can be at increased risk for confusion, slow reaction times, or distraction while driving due to symptoms of hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar).
Driving Safety and Diabetes
There are precautions that people with diabetes should take to ensure they are safe behind the wheel. Always check your blood glucose before you get behind the wheel and at regular intervals during long drives.
Diabetes UK: Road Safety
In the interest of road safety you must be sure at all times you can safely control a motor vehicle. Do not drive if you have just started to take insulin and your diabetes is not yet properly controlled - your doctor or diabetes specialist nurse will be able to give you more advice on this.