Driving license: driving with diabetes

Most people with diabetes drive without major problems. However, hypoglycemia can become a problem at the wheel. If blood glucose levels drop too low, attention, concentration and reaction time usually decrease. Dangerous situations can arise quickly in road traffic.

Who has diabetes and knows, that he is prone to hypoglycemia, must ensure that the values at the wheel do not drop too low. If a person cannot perceive the appropriate warning signs, he or she must not drive a car.

Six tips to avoid hypoglycemia at the wheel

1. measure blood glucose before driving. If the blood glucose level is too low, eat one to two BE/KE of fast carbohydrates and do not drive until the blood glucose level has risen again.

2. Record blood glucose level and amount of carbohydrate eaten. This is how they document their responsible handling of diabetes, should it become an issue after an accident.

3. keep dextrose tablets, keep a bag of liquid glucose or other quick carbohydrates handy next to the driver’s seat. The compartment in the driver’s door, for example, is well suited for this purpose.

4. Take cereal bars, fruit or other snacks as an "emergency reserve with. You can store these in the glove compartment. Store fast carbohydrates such as glucose within easy reach.

5. Take a break every two hours on long journeys. Check and document blood glucose levels.

6. Stop at the slightest sign of hypoglycemia and consume glucose or other quick carbohydrates. Do not continue driving until blood glucose has risen and hypoglycemic symptoms have subsided. Stop again after half an hour to measure again. Do not forget to note down the values.

Conditions for driving with diabetes

Because of the risk of hypoglycemia, diabetics who want to obtain a driver’s license are subject to certain requirements. The assessment guidelines of the German Federal Highway Research Institute specify the cases in which a patient with diabetes is unfit to drive. It depends on the personal risk of hypoglycemia as well as the type of vehicle.

  • There are no restrictions for people with diabetes who use a car low risk of hypoglycemia and have a class 1 – i.e. car or motorcycle drive.
  • Who susceptible to hypoglycemia is able to drive vehicles of the Class 1 drive when his metabolism is well adjusted by a doctor and he has received training. therapies with insulin, sulfonylureas and their analogues are associated with an increased risk of hypoglycemia. In addition, the guideline advises metabolic checks. Measure your blood glucose level before you start driving.
  • Anyone with diabetes who uses a vehicle of the class 2 – truck, bus, cab If you want to drive, you have to prove that your metabolism has been stable for the last three months, even if you have not had a diabetes test no increased risk of hypoglycemia owns. If you are trying to control your blood glucose levels with a healthy diet or plenty of exercise, you should seek the advice of a specialist in internal medicine or a diabetologist. If you are taking medication with a low risk of hypoglycemia, you are required to have regular medical check-ups and a specialist follow-up examination.
  • In the case of therapy with sulfonylureas or insulin in addition to medical check-ups, a specialist assessment is required every three years if a diabetic drives a vehicle of the Class 2 would like to lead.

In general, anyone who has had a severe hypoglycemic episode in the last twelve months during which they were dependent on outside help is not fit to drive, according to the Federal Highway Research Institute. They should not drive again until they can prove that their metabolism is under control and that they can detect hypoglycemia.

Typical secondary diseases of diabetes can also restrict fitness to drive. For example, if affected persons have poor vision as a result of retinal damage (retinopathy), as well as in the case of renal insufficiency or certain cardiovascular diseases. If in doubt, always ask your doctor if there is any reason why you should not get behind the wheel.

Expert opinion on fitness to drive

If you already have your driver’s license and only then develop diabetes, you do not have to report the disease to the authorities. No health questions need to be answered when converting to the new EU driver’s license either.

If the driving authority learns that someone has diabetes (as a result of an accident, for example), it can ask the person concerned to prove in a medical report that he or she is fit to drive. Patients are best advised to consult a diabetologist with additional qualifications in traffic medicine. The search engine of the German diabetes Society offers a filter for this purpose. Important: the assessor must not be the attending physician.

Changing therapy can be worthwhile

Drugs such as sulfonylureas carry an increased risk of hypoglycemia. In this case, patients can ask their attending physician whether a change in therapy is possible.

Caution: after a change in therapy, for example if the medication has been changed or the dose increased, patients should refrain from driving for the time being. On the one hand, hypoglycemia can occur more frequently after a changeover. On the other hand, temporary visual disturbances are possible if the sugar levels have been high for a long time and then fall.

training a sense for hypoglycemia

Especially in older and long-term diabetes patients, typical hypoglycemia warning signs such as trembling or sweating may not occur despite low blood glucose levels. Anyone who suspects that their hypoglycemia perception is disturbed should definitely talk to their doctor about it. In special courses, patients can learn to pay more attention to their body’s cues again.

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Christina Cherry
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