Driving Isn't An Issue for Most People With
TUESDAY, Dec. 20 (HealthDay News) -- Diabetes needn't prevent
someone from driving, and only a doctor should decide if
complications are severe enough to keep an individual off the road,
the American Diabetes Association (ADA) says.
In a new position statement published in the January issue of
Diabetes Care, the association advises against blanket bans or restrictions. Instead, it recommends that patients who have issues that might pose a driving risk be assessed by a physician who normally cares for people with diabetes.
"There have been inappropriate pushes to try to restrict driving licensure for people with diabetes, and we were concerned that these recommendations were coming from people who didn't really know diabetes, and were unnecessarily restrictive," explained Dr. Daniel Lorber, chair of the writing group that developed the position statement and director of endocrinology at New York Hospital Queens in New York City.
"The vast majority of people with diabetes drive safely," said Lorber. Currently, states have different laws concerning driving and diabetes, and the ADA would prefer to see a standard questionnaire used to assess driving safety.
Nearly 19 million people in the United States have been
diagnosed with diabetes, a disorder involving blood sugar levels.
The biggest concern about drivers with diabetes stems from the risk
of low blood sugar (hypoglycemia), which can cause confusion and
disorientation. While an episode of hypoglycemia can affect driving
ability, the ADA says such incidences are rare.
An analysis of 15 previous studies on people with diabetes and
driving found that overall, people with diabetes have between a 12
percent and 19 percent increased risk of a motor vehicle accident
compared to the general driving population.
But, society tolerates riskier driving situations all the time.
A 16-year-old boy has a 42 times higher risk of getting into a car
accident than a 35- to 45-year-old woman, according to the ADA.
People with attention-deficit hyperactivity disorder (ADHD) have
about four times the car accident risk of the general public, while
those with sleep apnea are about 2.4 times more likely to
"The challenges are to identify high-risk individuals and develop measures to assist them to lower their risk for driving mishaps," wrote the ADA committee.
For example, people with diabetes who take insulin are most at
risk of hypoglycemia. The ADA recommends that people who take
insulin test their blood sugar before driving and retest at regular
intervals if they're driving for longer than one hour.
"Patients with type 1 diabetes are really normal these days. There's no reason to restrict their driving ability," said Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City. "Patients are very smart today, and have more technology to help them manage their diabetes and avoid hypoglycemia."
For those at risk of serious hypoglycemia, the ADA recommends
not starting an extended drive with low normal blood sugar levels
(between 70 and 90 milligrams per deciliter) without consuming some
carbohydrates to prevent against a drop in blood sugar while
driving. The ADA also recommends having a fast-acting source of
carbohydrate (fruit juice, hard candy or dextrose tablets) to
quickly raise blood sugar available in the car and keeping an extra
snack, such as cheese crackers, handy, too.
Other factors related to diabetes that could affect driving
include diabetic eye disease (retinopathy) and nerve disease
(peripheral neuropathy). Retinopathy can affect vision and
neuropathy can impair the ability to feel the gas and brake pedals.
If these complications are severe, driving may become an issue.
The ADA recommends that people with diabetes who may pose a risk
while driving be evaluated by a doctor familiar with diabetes. If
the condition threatens the driver's ability to drive safely,
doctors can provide information to state licensing agencies. The
ADA doesn't recommend mandatory physician reporting, because it may
keep people with diabetes from discussing these issues with their
"The great majority of people with diabetes do not have an impairment in their driving, and I applaud the ADA for their position," said Zonszein.
The bottom line for people with diabetes, said Lorber, is to
"know what your sugar is before you start to drive, and don't drive
if you're below 70 mg/dL."
Read more about diabetes and driving at the
U.S. National Highway Traffic Safety
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Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.