Driving With Diabetes

As we noted here at Diabetes Flashpoints last year, people with diabetes face a variety of restrictions and prohibitions for certain jobs and activities, including military service, commercial driving, and piloting airplanes. Some guidelines — such as those governing eligibility to drive a school bus — vary from state to state, with some states declaring people with insulin-treated diabetes ineligible and others evaluating people with diabetes on a case-by-case basis.

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In a new policy statement, the American Diabetes Association (ADA) notes that there is also variety in how people with diabetes are treated when it comes to private, noncommercial driving. Some states ask on license applications whether the applicant has any medical condition that may interfere with his ability to drive, while 23 ask flat-out whether the person has diabetes. If the answer is yes, most states require a doctor’s certification that the individual’s health condition does not pose a threat to driving safely. The ADA recommends that states determine fitness to drive based on individual rather than group criteria; for example, whether someone experiences frequent hypoglycemia rather than whether someone takes insulin.

As an article on the ADA’s statement at DiabetesInControl.com notes, previous studies suggest that people with diabetes are between 12% and 19% more likely to be involved in a car accident than members of the general driving population. Other groups of people, however, have a much higher accident rate: Those with attention deficit hyperactivity disorder (ADHD) experience about four times as many accidents as the general driving population, while a 16-year-old male is about 42 times as likely to be in an accident as a 35- to 45-year-old female. Given these statistics, it seems irrational to single out diabetes for special treatment when it comes to driving.

Yet there are undoubtedly some people with diabetes whose condition makes them unfit to drive, some of whom — since people with diabetes are, after all, only human — do not realize or refuse to accept that this is the case. One way to address this issue could be to require all doctors to report health problems that may interfere with driving to the Department of Motor Vehicles. The ADA recommends against this approach, however, since mandatory reporting might discourage patients from discussing problems with their doctors, lest they lose their driver’s licenses.

What do you think — should all people be evaluated on an individual basis when determining fitness to drive, or is it acceptable to single out certain health conditions? Should a medical examination be part of getting or renewing a driver’s license for everyone, or for certain individuals? Should a history of hypoglycemia disqualify someone from driving? Under what circumstances would you voluntarily give up your driver’s license? Would better public transportation make the decision not to drive easier? Leave a comment below!

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