Driving and Diabetes
Driving and the EU law
News release: EU changes night-time hypos driving rules for people with diabetes
Driving and hypoglycaemia – what are doctors being advised to do?
Test Strips – Department Of Health Warning For Doctors And Pharmacists
Vehicles You Can Drive
Insulin and Driving Taxis
Hypoglycaemia and Driving
Driving and Medicines
Driving and Visual Field Loss
June 2013 Update
The DVLA reminds motorists when they should tell them they have diabetes
In June the DVLA issued a statement to remind motorists of the driving licence requirements if they have diabetes. It can be confusing, so here is what the DVLA said.
Group 1 – cars and motorbikes
- Motorists who control their diabetes by diet or tablets do not normally need to tell DVLA, but they do if they are on insulin.
- Motorists do not need to notify DVLA if they are on any non-insulin medication unless they have suffered from 2 episodes of severe hypoglycaemia within the last 12 months, developed impaired awareness of hypoglycaemia or suffer visual problems.
Group 2 – buses and lorries
- Motorists need to tell DVLA if you have any form of diabetes for which you take medication.
- If Group 2 motorists are on insulin, they need to:
[i] provide 3 months of continuous meter readings every time they apply for a licence,
In case you are confused by the term non-insulin medication, IDDT assumes that this phrase is being used to not only cover tablets but also the newer injected drugs for Type 2 diabetes, Byetta and Victoza. These are injected but they are not insulin.
August 2012 Update
DVLA – YET More Confusion For Lgv Drivers!
The changes in the driving regulations were positive for people with vocational licences to drive buses or lorries [LV licenses] – they allowed people treated with insulin to apply for an LGV licence. However, IDDT has been informed by one of the Transport unions that applicants with diabetes are falling foul of the strict new criteria that were also introduced.
A man being treated with tablets who had been classed as fit to drive at his medical, had his licence LGV revoked because he could not prove that he had been testing his blood glucose levels twice daily for the last 3 months. He cannot re-apply for another 3 months which obviously is putting a strain on his livelihood. He feels dismayed that the DVLA did not do enough to make drivers aware of the strict criteria.
The Union fears that many LGV drivers with diabetes believe that the new regulations only apply to people taking insulin and that they could have a similar shock when they re-apply for their licences.
A further problem arises because many drivers are not being prescribed enough test strips to be able to test twice daily. In the example above, the driver was only receiving 50 strips a month – simple arithmetic shows this is not enough!
The Union tried on a number of occasions to obtain clarification from the DVLA and only after considerable time, did the DVLA respond with the following statement:
"There is a legal requirement that Group 2 (lorry and bus) drivers with diabetes who are either treated with insulin or with tablets which carry a risk of inducing hypoglycaemia must check their blood glucose (sugar) level at least twice daily and at times relevant to driving. For those drivers who are insulin treated, this must be done with a blood glucose meter with a memory function. DVLA will require drivers to sign a declaration confirming that they will do this. Failure to meet the monitoring requirement will lead to the revocation or refusal of their Group 2 licence."
In the light of this statement, it is essential for LGV drivers with Type 2 diabetes treated with tablets to be aware of the type of drug they are taking because the first line treatment is with metformin which is classed as NOT carrying the risk of causing hypoglycaemia. However, if treated with sulphonylureas, the second drug to be introduced if blood glucose control deteriorates, does carry the risk of hypoglycaemia.
IDDT’s advice to LGV drivers on tablets is as follows:
- If treatment is with metformin only, then they are not obliged to test twice daily for 3 months before applying or re-applying for their LGV licence.
- If treatment is with sulphonylureas or other drugs for Type 2 diabetes, then they must test twice daily for 3 months and when driving. They must use a meter with a memory so that they can prove they have complied with the regulations.
- If drivers are unclear which medication they are taking, they should check with their GP.
- Drivers must insist that their GP prescribes enough test strips to enable them to test at least twice daily and at additional times if necessary.
IDDT reminds LGV drivers on insulin or tablets which carry the risk of hypoglycaemia of the following regulations for an LGV licence to be granted:
- There has not been any severe hypoglycaemia event in the previous 12 months.
- The driver has full hypoglycaemic awareness.
- The driver must show adequate control of the condition by regular blood glucose monitoring, at least twice daily and at times relevant to driving.
- The driver must demonstrate an understanding of the risks of hypoglycaemia.
- There are no other debarring complications of diabetes.
IDDT has promised to give this situation as much publicity as possible in the light of the lack of information and publicity given by the DVLA.
On June 21st 2012 the DVLA issued new guidelines aimed at making it easier for drivers with diabetes treated with insulin to understand the new driving rules to comply with the European Directive introduced in 2011.
Along with many other organisations, IDDT complained to the DVLA and the Minister of Transport that the questions on the application form were not easy to understand and were misleading. This applied particularly to those about severe hypoglycaemia and as a result they have been giving the wrong answers, and so have their doctors. In some cases this has meant that licences have been lost unnecessarily.
The DVLA makes it clear that hypoglycaemia is classed as blood glucose levels below 4 mmols/l and the new form now asks the following questions relating to hypoglycaemia:
- If you have NOT experienced an episode of hypoglycaemia, are you aware of what the symptoms are?
- If you have had an episode of hypoglycaemia, do you get warning symptoms? If yes, are you always aware?
- Have you had more than one episode of severe hypoglycaemia in the last 12 months? Please only count episodes where you needed help. Do NOT count episodes where you were given help but cold have treated it yourself.
Further points to clarify some of the questions that IDDT has been asked are:
- You MUST sign the declaration that you will test before and every two hours when you drive. [This is to let the DVLA know that you understand that you have to test while driving.] This is a legal requirement and a licence will not be issued if this declaration is not signed.
- For numerous short journeys you do not have to test before each journey as long as you test every two hours while driving.
Type 2 diabetes and are treated with diet only
If you receive the medical assessment for [Diab 1] and you are treated with diet only, then you do not to complete section one. You should send the form back to the DVLA with a covering letter explaining your treatment is diet only./p>
However, if you have had laser treatment in both eyes [or the one remaining eye if you only have one eye] then you need to fill in Section 2 of the Diab 1 form.