Diabetes Self-Management Blog

Has diabetes affected your experience of driving? It can. How about getting licensed to drive? In some states, diabetes can make obtaining a driver license much harder.

The biggest risk in driving with diabetes is low blood glucose. Our brains run on glucose, and when glucose gets low, it’s very hard to think or react. This is why authorities can be suspicious of people’s ability to drive with diabetes.

One of the largest studies on safe driving with diabetes was published by University of Virginia researchers in 2003. At diabetes specialty clinics in seven US and four European cities, about 1,000 adults with Type 1 diabetes, Type 2 diabetes, and without diabetes completed an anonymous questionnaire concerning diabetes and driving.

The results showed that drivers with Type 1 reported significantly more crashes and moving violations. Drivers with Type 2 did not, even when they were on insulin. Nearly all the accidents were related to hypoglycemic (low blood glucose) episodes. People who injected insulin were more likely to crash than those who used an insulin pump. Fewer than half of people with either type had discussed driving with their doctor.

The researchers found that not checking glucose before driving was a big risk factor for accidents, and “encouraged [all physicians] to talk to their type 1 diabetic patients about hypoglycemia and driving.”

There may not be studies, but on many Internet bulletin boards, people with Type 2 have reported difficulty driving from either high or low blood glucose. People talk about “brain fog” as a symptom that can come from lows or highs. Some commented that for people who typically run high, getting down to “normal” can feel like having a low and fog your thinking.

If you ever feel fuzzy while driving, the American Diabetes Association’s (ADA’s) advice for teens with diabetes might be useful. They suggest the following:

• Check your blood glucose every time you get into a car.

• Treat low blood glucose even if it means being late. It’s never OK to drive with a low blood glucose level. Call whoever is waiting for you and explain why you’ll be a little late.

• Stock the car with healthy, nonperishable snacks and fast-acting sugars. And keep your diabetes supplies within easy reach.

• Pull over immediately if you are feeling sick or low while driving. Check your blood glucose, treat yourself, wait 15 minutes, and then recheck.

Diabetes and Your License
Most states ask on your license application if you have a health problem that might interfere with your driving. If you answer “yes,” they will want information from your doctor saying that you can drive safely.

The ADA has a list of each state’s rules and regulations here. On this page, they say that

This information focuses on driving rules and policies that relate to altered consciousness and other possible effects of very low or very high blood glucose levels… Many [states] do not ask specifically about diabetes but ask more generally about conditions that may cause loss of consciousness or may impair driving ability.

You have to pay close attention to the wording of medical oriented questions to determine whether your answer is “yes” or “no.”

But long-term complications of diabetes, especially neuropathy and eye disease, can cause other driving problems. The ADA says,

These medical conditions may be addressed by different medical rules or guidelines, such as vision standards. Contact the licensing agency in your state for information on these rules.

If you are stopped for bad driving while running low, you may be taken for someone who is drunk. The officers may not be helpful in getting your glucose back up. My motivation for writing this blog entry was a report and video I saw of officers beating a driver with low blood glucose because he wasn’t “cooperative” enough.

Of course, from a safety perspective, driving low and driving drunk are pretty much the same thing. Driving with a foggy brain isn’t a good thing either. Have you experienced anything like that? How did you stop it from happening?


Driving With Diabetes
Driving With Diabetes
Driving With Diabetes

  1. If you live in a rural area, it’s often tough to find reliable, available, inexpensive ways to get where you need to go. Public transit is often very limited. So, your license is critical to your travel needs. I’m type one for over four decades, and currently my hypos are often very subtle. So it is easy to go low without picking up on your change in b.g. status; therefore, the seven-plus continuous glucose monitor that I use has been very helpful. The monitor has programmable alert levels for lows, highs. rises, and drops in b.g., and the alarm can be set to respond more or less aggressively for each of the applications. It has prevented problems both with driving and dangerous hypos in other circumstances, and it has many other features that make it an asset in managing this complex disease of type I diabetes.

    Posted by Frank |

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