Having a driver’s license is a significant responsibility because it impacts your safety and the safety of other drivers around you. Each state has specific laws about driving and diabetes. Find out why risks could be higher for drivers with diabetes and what you can do to maintain your driving privileges.
Most people need to drive to accomplish certain things in a day such as getting to work, school, medical appointments, shopping for food and other important things. There are certain organizations dedicated to representing all people with diabetes that state “laws make it harder for drivers with the condition” which may be discriminatory. Each state has laws related to driving with diabetes, whether you want to get a non-commercial or commercial driver’s license. Some have restrictions and others do not. It is important to find out the laws in the state where you reside.
Hypoglycemia and Driving
Many people have “diabetes” noted on their license for added protection. In some states, your license can be taken away if you experience severe hypoglycemia or low blood glucose that requires treatment. Know the signs of hypoglycemia – shakiness, dizziness, fast heat beat, visual disturbances, irritability, sweating and confusion.
Low blood sugars often mimic the symptoms of drinking too much alcohol, so police like to know if diabetes may be a factor. Wearing diabetes ID as a necklace or bracelet, may also help when there is a question concerning low blood sugars versus drinking too much alcohol. A person must maintain healthy blood sugar levels for a designated period or prove it will not occur again.
The good news is hypoglycemia can usually be prevented by testing frequently and having a glucose source with you. Always carry a container of glucose tablets and prepackaged cheese/peanut butter crackers in your glove compartment and be prepared with other healthy snacks to correct low sugars when you are driving.
Hyperglycemia and Driving
While hypoglycemia is a problem, hyperglycemia is also an issue for drivers with diabetes. High blood sugar can be a problem with symptoms such as severe fatigue, confusion, lack of concentration and blurry vision. These symptoms could impact your ability to drive safely. Hyperglycemia is usually considered 200mg/dl or more. The goal is to keep your blood sugar in an acceptable range while you are on the road. A safe range for driving before a meal should be around 90 – 120 mg/dl. After eating, averages should be under 180 mg/dl.
Extra tips for driving with diabetes:
- To help keep blood sugars in check, avoid alcohol before driving.
- Do not skip meals or over eat especially before driving.
- Always take note of changes in your routine that could impact your blood glucose levels. These include updates to your diabetes medication and insulin, illness or infection, pregnancy, high stress levels, exercise, travel, and lifestyle changes.
- Carry personal identification that shows you have diabetes in case of accidents or injuries. Keep emergency contacts in your cell phone under “ICE” so response people can easily find this information.
- Keep a list of your other health conditions, medications, doses and physicians name and phone number in the glove compartment, in your purse or wallet.
Type 1 Diabetes and Driving
People with type 1 diabetes recognize the need to balance blood glucose levels to prevent hypoglycemia and hyperglycemia. With type 1 diabetes, there may be a higher risk of blood sugar fluctuations that can lead to confusion, blurry vision, and sleepiness. In extreme cases, people with type 1 may experience a seizure and loss of consciousness. Studies have shown drivers with type 1 diabetes are at a higher risk of getting into car crashes and tend to have more moving violations that drivers without diabetes. High blood sugars in those with type 1 diabetes, may result in diabetic ketoacidosis or DKA, which causes a fruity breath, similar to drinking large amounts of alcohol.
Type 1 diabetes driving tips:
- It is important to test your blood sugar before driving and wait until your levels balance out. Always have a sugar source accessible in your car and on your person in case your blood sugar plummets.
- Have snacks handy to eat to get your levels under control. Wait at least 15 minutes before getting on the road again.
- Carry a blood glucose monitor in your vehicle. Watch for danger signs, such as a rapid heartbeat, perspiration, and irritability.
- Pull over immediately if you have any low or high blood sugar signs or symptoms.
- If your symptoms are persistent or severe, call 9-1-1.
Teen Diabetes Drivers
For all teens it is a “rite of passage” to get a driver’s license. As new drivers, they are often excited to get behind the wheel right away. Inexperience combined with diabetes can increase risks for teen drivers. Parents need to talk to teens about safe driving and practices with diabetes.
Safe driving and best practices for teens with diabetes:
- Knowing the signs of high and low blood glucose levels and how and when to treat them.
- Have the teen put together an on-the-road care package with rapid-acting carbohydrates, glucose tablets, snacks with carbohydrate and protein and bottled water.
- Review medication and insulin schedules with your teen as well as the need to test blood glucose levels regularly.
- Let teens know they should not leave glucose meters, insulin or test strips in the car as temperature changes can damage them.
- Pack an insulated bag with necessities that can be quickly taken in and out of the car. This is a good way to help keep teen drivers healthy and safe.
- Encourage the teen to wear a necklace or bracelet that shows they have diabetes in the event of an incident on the road.
- Have them make routine breaks when driving long distances of more than 1 hour.
- Keep an ICE emergency contact in their cell phone.
- Make sure they carry their health insurance card at all times.
Senior Diabetes Drivers
As people get older, they may develop other health conditions besides diabetes. Seniors may also have arthritis, vision loss, hearing loss, balance issues, orthopedic problems and other issues that could make it more difficult to drive. Driving is a complex skill that requires quick reflexes, sharp senses, and the ability to know what is going on at all times. This can be impossible for seniors with conditions with memory loss such as dementia. As people get older and develop health problems, they should talk to their health care team about driving. Some older adults have a fear of losing their independence and may not mention it.
- Concerned family members can consult with the older person’s doctor to find out whether driving is advisable. Physicians can actually recommend removing a senior’s driver’s license; they may be more receptive to a physician compared to a family members suggestion.
- Seniors should be reminded there are other ways to get around and maintain their freedom. These include walking, taking a bus, calling for an Uber, a taxi or driving service, subways, trains, biking, and contacting a friend, family member, or community organization for seniors to get a ride.
According to published research, people with diabetes have an approximate 12-19% increased risk of having an accident. Other study results are mixed. Factors such as the location, meals eaten, your exercise schedule, and diabetes medications may have an impact on the level of risk. The greatest driving risk for those with diabetes is hypoglycemia.
Best practices to avoid accidents:
- Plan meals, accordingly, especially if you know you will be driving more than one hour.
- Hypoglycemia can have an adverse impact on your judgment and safety. Maintaining healthy blood sugar levels are essential to be a safer driver.
- If you detect any strange feelings or symptoms, pull over at a rest stop or parking lot periodically to monitor your blood glucose levels.
- If blood sugars are under 90 – 100mg/dl and you still have a long distance to drive, have a snack even without low blood sugar symptoms.
- Alert a friend or family member with a phone call that you may be experiencing hypoglycemia and to check on you while you are still on the road.
- Make sure to have glucose tablets and snacks with carbohydrates and protein such as fruit and nuts or crackers with cheese and water in case of an episode.
- Immediate self-treatment makes a huge difference. Preparation is the most important way to prevent a problem on the road.
Diabetes-Related Health Complications
People with diabetes-related health complications, such as high blood pressure, heart arrythmias, sleep apnea or reduction of vision, need to take special care on the road. Another concern is nerve damage or diabetic neuropathy. Numbness in your feet can make it difficult and unsafe to drive. Work with your health care team to keep diabetes and related health complications under control. Take medications as directed. Maintain regular appointments with specialists to monitor your conditions and make changes as needed.
Other solutions for monitoring glucose levels while driving
There are driving solutions that could make a major difference in the future. Right now, patients can wear a CGM or continuous glucose monitor which can provide blood sugar trends and information before it actually happens, whether blood sugar is going up or down.
A prototype of a smart car that alerts drivers of low blood sugar levels also already exists. Users access their phones through the Sync system to tap into a continuous blood glucose monitor. As the car goes down the road it tells the driver his or her blood sugar levels.
Watching out for innovative technologies is another way for drivers with diabetes to stay safe and mobile. Talk to your doctor about the latest updates related to driving and diabetes.
Staying Safe on the Road
- To stay safe on the road consider testing your blood glucose before driving.
- If you are taking a long road trip, plan your stops ahead of time. It can help to establish a schedule for eating and testing your blood sugar. Your goal is to check your blood sugar every two hours.
- Never skip meals when you are traveling even when you are in a rush. Pack a sandwich and fruit to be eaten.
- On a long-term basis, take care of your eyes to protect yourself from retinopathy or diabetic blindness. Get a dilated eye exam annually.
- Wear sunglasses while driving to keep your eyes protected from developing cataracts.
A large number of people with diabetes drive safely for many years. Conscientious planning is the best way to stay safe on the road and maintain your driving privileges. Taking the proper precautions keeps everyone safe, happy, and free to enjoy the open road!