• You must also tell your car insurance company that you have diabetes. Again, this responsibility is yours. It is silly not to tell them, because if you make a claim and have not revealed your diabetes they may refuse to pay, whether the accident was your fault or not. They may also refuse to pay if you have not told the licensing authority.
    Driving with diabetes is not simply a matter of getting official approval. It is important that you and other road users are completely safe. What factors should be considered if you want to drive a car? First, are you at any risk of becoming confused or unconscious? Never drive any vehicle if your blood glucose is below 4 mmol/1 (72 mg/dl) or if you feel hypoglycemic.
    If you need to make a journey just before a meal, eat a snack before you get into the car. You must have glucose in the car, and you should have enough food in the car for an extra meal in case of breakdowns or delays. Some people with diabetes who do a lot of travelling, carry their diabetes travel pack in the car all the time in case they need to spend a night away from home.
    If you feel at all hypoglycemic while you are driving, stop as soon as it is safe to do so, turn off the engine and remove the ignition keys. Then have something to eat. You should also slide into the passenger seat so that you are not ‘in control of the vehicle’. Remember that you may not be thinking straight or be properly coordinated if you are hypoglycemic. I heard of one man who drove five miles while hypoglycemic and left a trail of destruction throughout the entire length of a village street.
    Next, you should consider whether you have any complications of diabetes which may make driving hazardous. An obvious one is diabetic retinopathy. Most people with retinopathy can see well enough to drive but it is important that you have your visual acuity and your visual field (all round vision) checked regularly. If you have had a lot of photocoagulation your visual field may be narrower than before. If you have maculopathy (damage to the area of best vision) you may not be able to see well enough to drive. Cataracts may also block your vision for driving and this may be an added reason to have them removed.
    If you have numb hands or feet from diabetic neuropathy you may not be able to feel the controls of the car very well; and if you have heart trouble, you should discuss driving with your doctor. The current advice is that you should not drive for at least one month after a heart attack. If you have angina that may be brought on by stress, such as road hogs and traffic jams, you should certainly not drive.
    *109/102/5*
    DIABETES

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  • The legal requirements for driving differ in different countries, but most insist that you notify them of any illness that may impair your safety as a driver. For example, the old British driving license states:
    You are required by law to inform Driver and Vehicle Licensing Centre (DVLC) … at once if you have any disability which is or may become likely to affect your fitness as a driver, unless you do not expect it to last for more than 3 months.
    The new license mentions diabetes specifically. The DVLC is now the DVLA. Drug-treated diabetes counts as such a disability because people on drugs which lower the blood glucose (this includes insulin) are at risk of hypoglycemia and confusion or coma. It can be argued that any form of diabetes counts because of the theoretical risk of hyperglycemic como, or the later need for glucose lowering treatment, or because some of the complications of diabetes may make driving unsafe. To adhere to the letter of the law, even diet-treated diabetics should inform the DVLA of their diagnosis, clearly stating that they are not taking blood glucose lowering drugs at that time.
    It is your responsibility to notify the authorities and not your doctor’s. The licensing authority may then request details of your condition from your doctor who can release them only with your consent.
    *108/102/5*
    DIABETES

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