Driving With Diabetes

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?

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  • Frank

    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.

  • Craig

    Ok, I’m coming here to vent. This is outrageous. I’ve been T1 for 20 years, no accidents, clean record, absolutely harmless driver. Seeing the red tape that is being pulled across driver’s license renewals all in the name of “safe driving” is pure unadulterated discrimination. You’re asking me to disclose whether I’m a Type 1 diabetic- in which case I’m forced to see a/NOTHER doctor, pay for the appointment and time, just so he can confirm the same? GFY!

    Having this disease is a jail, pure and simple. It’s purgatory enough to check our blood sugar 8x daily and manage our BG within a tight range (so as to prevent complications in the future) *without* being hammered by ignorance and discrimination from those with no medical background whatsoever. At the DMV, the Ministry of Transportation or wherever you live in the world… do you think I’m ‘only’ diabetic when I come in to renew my license? Do you think it’s ‘only’ when you ask me the question that I need to confront my medical status, or worry about when I’m going to eat next, balancing my diet with exercise and insulin? Do you think I need your REMINDERS once every 3-5 years to control this disease?! Because I got news for you: I don’t. Whether you see me or not, I’m a diabetic. I’m a diabetic when you’re at work, when you’re at home or on vacation. I don’t take breaks. There are no exceptions. I’m not doing this of my own volition. Don’t talk to me like this world needs you to “keep me in line…” “Did this guy take his insulin this morning…” “Does he know what his blood sugar is…” “Maybe he need a chocolate bar right now…” GTFOH!

    It drives me crazy. As if the system doesn’t bombard enough costs and burdens on patients that they need to also choke us of our last dime by subjecting us to supplemental tests, further medical reviews and all kinds of other (ineffective!) nonsense.

    I’ll tell you again: I don’t need anyone’s pressure to keep my body in shape and healthy. I live with that pressure every day, I’ve accepted it, and my results speak for themselves. What’s more, I’m not the only one. My life is more important to me than it will ever be to the DMV, or the government… or the people with whom I share the roads for that matter. If I’m feeling a low mmol, for example, I don’t need you to tell me to pull over! Christ! I’m doing it before anyone tells me, “Oh it says here in Line 6a of the document…” FOH! If you’re hungry, you eat! If you’re tired, you sleep! If your sugar is low, you pull over and you restore your level! To ‘force’ these silly responsibilities and ancillary costs into the fine print of everyday living for a demographic that is already budgeting more on disease control, time and risk management than the healthy population, only reflects a system run amok.

    I have an endocrinologist with whom I meet on a regular basis. Believe it or not, he’s a medical professional… go figure! It’s his opinion that I respect when it comes to matters of whether my driver’s license should be renewed with conditions- not some government outpost that is looking to meet a budget, and force me on a wild goose chase in order to do it. He has all the authority in the world to suspend my license- and if that were to transpire, I would 100% respect it because at least he’d be an informed party. Conversely, going into an office to stand on the other side of a kiosk from some random clerk who’s being paid by the hour to EVALUATE OUR MEDICAL FITNESS FOR DRIVING belies all common sense.

    In fact, I’d go further. I’d say it’s systemic discrimination against a people who already face a stacked deck in life. You’re not enforcing responsible driving on the roads today- e.g. drivers preoccupied with other things and people in the cabin, for instance; you’re not trying to correct poor habits gone unchecked for so long that at least 90-95% of drivers (healthy or otherwise) would fail their exams if they drove the same way they do on the roads every day; you are instead demanding that an arbitrary group (who never asked for their disease, by the way) perfectly capable of driving- among other things- to prove to you that “everything is in order” ohhh … just because.

    For anyone to believe that this is being done for safety makes my blood boil. All it does is sustain the economy in a world run by insurance. My endo- my diabetes doctor! Key word: Diabetes!- will tell you if you need to suspend my license… not some stranger at a walk-in clinic who makes the assessment on a pair of stupid questions that even he doesn’t know how to interpret.

    As a patient in this world, you don’t get anything. You just have people trying to smother you as if it’s not bad enough already. You have a society that’s trying to feed itself on the back of your misfortune. It’s like Kirk Douglas in “Greedy”, I feel like a billionaire on my deathbed who’s being visited by family I haven’t seen in years… is it a coincidence they’re holding a copy of my will?

    We might want to ask ourselves why there hasn’t been a cure brought forth for anything significant since the emergence of powerful technology and universal education. It doesn’t make sense. Getting all this paperwork to ‘prove’ a diabetic’s health prior to issuing a driver’s license is just one example- I mean, these tests even if they work don’t achieve the goal, that’s my point! You’ll decide on the basis of one isolated reading (by a doctor who doesn’t even specialize in the disease) whether a patient is fit for driving for the next 3-5 YEARS?! It’s laughable. All it does is inconvenience the patient further and pour salt on the wound. It’s a stupid law written by people who don’t know how (or want) to solve problems. They’re just lining their pockets at our expense again.

    Tired of it.