From Maine, USA:
Our daughter is a 14 year-old diagnosed 5 months ago. As she approaches driving age we worry that many states don't allow diabetics to drive. It seems I quite frequently hear of diabetics blamed for car accidents. Is there any likelihood of more states joining the ban? (I use license eligibility as a "carrot" to motivate her tight control.)
This question was referred to everyone on the Diabetes Team, who have each given an answer:
Answer from Dr. Lebinger:Although every state in the US has their own regulations for obtaining a driving license, I do not believe any state in the US outright bans a diabetic from obtaining a license to drive a private vehicle. Most states do not allow anyone who has a history of passing out, becoming dizzy or having a seizure in the past 1 - 2 years to obtain a license.
As a practical point, driving with diabetes has to be taken very seriously! There is no question that many people with diabetes have been involved in car accidents when their blood sugar is low. Even if the driver with diabetes thinks he or she can "function normally" with a mild low blood sugar, reaction time is definitely increased with mild low blood sugars. (This means that it takes longer to react and brake, slow down, or turn to avoid an accident when your blood sugar is low.) This can significantly increase the risk of either the diabetic driver or an innocent pedestrian or other driver being involved in a serious or even fatal accident when the blood sugar is low.
I speak with all adolescents and their parents before they are old enough to obtain their driving permit about the realities and responsibilities of driving with diabetes. I also use obtaining a driver's license as a motivation to improve control, not as a punishment, but as a logical fact -- that the parents cannot allow the teen to drive unless they are sure that the teen's diabetes is in reasonable control as it would not be safe either for the teen or for others in society. I explain to the teen that their parents cannot force them to take care of their diabetes, but on the other hand they cannot allow them to drive if it is dangerous either to the teen or others.
I suggest that all teens test their blood sugar before getting behind the wheel and then at least every hour if driving a long time. I suggest that they leave some emergency food in the glove compartment that won't spoil such as cake decorating gel in addition to taking what they think they will need for the driving session. I have been told that some states require drivers with diabetes to also have emergency food within arm's reach when driving in case they feel low and can't stop to open the glove compartment. I think this is a good idea. I tell the teens even if they are just planning to drive around the block, to have enough emergency food for several hours. I joke with them, you never know when the President will plan a surprise visit to their neighborhood and their street will be blocked off for several hours!
When the proper precautions are taking, teens with diabetes can drive safely.
Answer from Linda Mackowiak, RN, MS, FNP, CDE, Diabetes Nurse Specialist:When I talk to teenagers about obtaining their driver's license, we discuss the responsibility of driving a car, both to not hurt themselves or other people. I ask that they check their blood sugar or be sure they have eaten very recently before driving, and to always have food available to them in the front seat. We also discuss the signs of low blood sugar besides the shaky, sweaty symptoms, that is the signs of blurry vision, fatigue, "mental slowness", etc. Unfortunately people with diabetes who are in 'tight control' have a greater risk of hypoglycemia.
Answer from Marie Springs, RN, CDE, Diabetes Nurse Specialist:In South Carolina, people with diabetes are allowed to obtain a driver's license. The only people with diabetes that are not allowed to drive are long distance truck drivers if they are on insulin (that law is now in the process of being changed).
Answer from Dr. Robertson:In the UK, people with diabetes can drive private cars but not any public or heavy goods vehicles. They must declare their diabetes to the licensing authority and provide evidence from a doctor that they do not suffer from severe daytime hypos.
Answer from Dr. Songini:In Italy, car licences are allowed to IDDM patients in good metabolic control and with minor complications after a complete medical visit before a NHS commission and a formal declaration of his/her diabetologist is required by the commission. They are not allowed to obtain driving licences for coaches, buses, trucks and/or similar. Licences are subject to be renewed every two years (compared to 10 years for people without diabetes) and this means more time and money spent for the bureaucracy.
Answer from Dr. Quick:I want to reemphasize two points made by Dr. Lebinger: Everybody with diabetes who's taking insulin, or who's subject to any chance of low sugar problems, should check their sugar level before driving, and every hour during prolonged trips. And keep some "real food" as well as some quick-acting sugar in the car, just in case.
Original posting 6 Jul 97
Last Updated: Tuesday April 06, 2010 15:08:53
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