Suzanne Leahy
BN RN, Credentialled Diabetes Educator,
Diabetes NSW
1
Driving & Diabetes
Driving is a complex skill both physically and mentally and
for people with diabetes, extra precautions need to be taken
when they drive, to help maximise road safety
The main hazard for those who take insulin or glucose
lowering medications is the unexpected occurrence of
HYPOGLYCAEMIA
Hypoglycaemia: Signs & Symptoms
Light headedness
Tearful/crying
Weakness, trembling or
shaking
Irritability
Sweaty
Lack of concentration or
behaviour change
Headache
Hunger
Tingling lips, fingers
Slurred speech
Dizziness
Unconscious/fitting
Causes of hypoglycaemia
Delaying or missing a meal or snack
Not eating enough carbohydrate
Too much insulin or diabetes tablets
Unplanned physical activity
More strenuous exercise than usual
Drinking alcohol
Treating hypoglycaemia
Step 1:
Quickly absorbed carbohydrate
5-7 jelly beans or
½ can soft drink or
3 tsp sugar or honey
Step 2:
Slower absorbed carbohydrate
1 glass milk or
1 piece of bread or
1 piece of fruit
What is ‘Above 5 to Drive’ ?
NDSS released Diabetes and Driving, “Above 5 to drive”!
Guidelines in 2011
The guidelines highlight the responsibilities of the driver
Responsibilities of the Driver
Recommendations:
 Test BGL before driving and ensure it is above
5mmol
 Carry fast acting carbohydrate food (or drink)
with you in the vehicle AT ALL TIMES
 Carry the blood glucose meter in the car
 Check your BGL every 2 hours if you are driving
long distance and ensure your level is above
5mmol/L
Above 5 to drive
What should you do when having a hypo whilst
driving?
1. Pull over safely
2. Remove the keys from the ignition
3. Eat some fast acting carbohydrate(at least 15g of glucose)
immediately, to treat the hypo
4. Follow up with some longer acting carbohydrate
5. Retest your BGL to ensure your blood glucose rises above 5
6. Wait AT LEAST 30 minutes after the BG reads above 5, and
confirm it remains above 5 before driving again
Driving & a recent severe hypo
A severe hypo is a hypo that someone else has to help you treat
Having a recent severe hypo means you are at risk of further episodes,
especially in the next few weeks
What to do?
 STOP driving, wait until you have clearance to drive from your
Doctor
 Review your blood glucose testing and/or treatment
 Determine with your Doctor whether you have “reduced hypo
awareness”
Above 5 to Drive
Follow the guidelines and be a
responsible driver
Consider the safety of your
passengers, other road users and
YOURSELF!
CARRY identification both on
yourself and in your car, indicating
that you have diabetes
Associated conditions
that may affect driving
Eyes – blurred vision - 12 monthly check
Sleep apnoea – can cause excessive daytime drowsiness and
loss of concentration while driving
Feet – numbness and pain may result in trouble
feeling the pedals when you drive
Surgical or Medical procedure – seek advice from your
Doctor to determine when you are fit to resume driving
Heart – Heart disease and high blood pressure are more
common in people with diabetes, see GP for regular monitoring
You also need to know
• It is your legal responsibility to advise the Driving
Licence Authority in your State if you take glucose
lowering medications including insulin
• If you are a commercial driver then an
endocrinologist may need to make
recommendations on your fitness to drive
• In NSW the RMS uses the national ‘Assessing
Fitness to Drive’ medical standards and guidelines
to assess drivers with diabetes
• Drivers with diet controlled diabetes DO NOT need
to report their condition to the RMS
Medical Assessments
Private motorists who treat their diabetes with tablets – every 5 years
Private motorists who treat their diabetes with insulin – every 2 years
Commercial licence holders must have a medical review every year
The new review date is calculated from the
date of the person’s last completed review,
and is rounded up to their next birthday
A few points
STAY “Above 5” at all times when driving
CARRY some form of fast glucose on your person and in the
vehicle at all times
TEST BG before driving and at least every 2 hours
ADVISE the RMS
REGULARLY consider your fitness to drive safely
IF a hypo occurs, pull over safely and immediately treat it
BE A SAFE DRIVER
Hypoglycaemia
If you are having episodes of hypoglycaemia (BGL’s less
that 4mmol/L) you should speak to your health care
professional as you may require a review of your
medication
Check BGL’s regularly and discuss the results
A change in your weight, exercise regime or medication
may increase your risk of having hypos
Regular review is essential!
For more information
www.austroads.com.au/drivers-vehicles/assessing-fitness-to-drive
Questions