Diabetes and Driving: Questions Answered

Deciding if a person with diabetes is at risk while driving should be done on an individual basis, according to a new position statement from the American Diabetes Association. The statement, which appears in the magazine Diabetes Care and was reported by MSNBC, says assessing a driver's ability to drive safely should be "tied to concrete evidence of risk, rather than on a diagnosis of diabetes alone."

The annual update of the ADA's Standards of Medical Care in Diabetes contains a section on driving and diabetes that calls for "individual assessment by a health care professional knowledgeable in diabetes" when considering restrictions for licensure.

"This country needs a far more consistent, fair, and equitable means of determining driving risk when it comes to people with diabetes," said Daniel Lorber, MD, FACP, CDE, according to MSNBC.

Added Lorber, who's director of endocrinology at New York Hospital of Queens in Flushing, New York: "The vast majority of people with diabetes have no problems driving safely whatsoever, and should not be held to restrictions that may interfere with their ability to work or live an otherwise normal life."

However, individuals with diabetes should always take certain precautions before they get behind the wheel—and while driving. Before you even get into the car to drive, test your blood sugar, says Alison Massey, MS, RD, LDN, CDE, registered dietitian and diabetes educator at the Center for Endocrinology at Mercy Medical Center in Baltimore. 

Ideally, your blood sugar should be above 70 mg., she says. If it's lower, eat a snack before you drive. And take your diabetes supplies with you in the car so you'll be able to check your blood sugar periodically during long drives, Massey says.

Take along some sweets as well. "I recommend that you have snacks in the car," says Mary Ellen Roberts, DNP, of the American Academy of Nurse Practitioners. "Keep hard candy or even a tube of gel icing that you can squirt under your tongue if feel yourself developing hypoglycemia."

If you suddenly feel hypoglycemic, pull your car over to a safe location immediately, says Massey. Test your blood sugar and if it's low, treat it with 15 grams of a fast-acting carbohydrate (4 glucose tablets or 4 ounces of juice or regular soda, for instance.) Wait 15 minutes and then retest your blood sugar to make sure it's gone up to the target range before starting to drive again.

Watch out for high blood sugar, too, if you're planning to drive. Hyperglycemia can cause symptoms like blurry vision, Massey says. "It could potentially impact your visual acuity, which is important for safe driving," she explains.

And, says Spyros Mezitis, MD, of Lenox Hill Hospital in New York City, high blood sugar also can cause weakness and lethargy—two reasons to not get behind the wheel. "If your blood sugar is over 300, you should not be driving," he says. If you have diabetic complications like retinopathy or neuropathy, these could impact your driving ability, too. "A diminished sensation in the hands and feet can certainly impact one's ability to drive safely in regards to operating the steering wheel and pushing the pedals," Massey says. "And diabetic retinopathy can impact vision in different ways."

To determine if your eye disease is advanced to the point where you should not be driving, get regular eye exams from your ophthalmologist and discuss any changes you've noticed in your vision, Massey advises.




"Driving and diabetes: one size does not fit all." 20 December 2011. Marketwire. Msnbc.com. http://www.msnbc.msn.com/id/45741348\