Driving and Diabetes: Does One Size Fit All?

For many, having a driver’s license is not only a great source of pleasure, but also an essential part of modern daily life. And what we first learn as teenagers bears repeating well into adulthood: Driving safely is an important responsibility and civic duty. (Can you recall your parents’ voices as they first handed you the keys?)

But it’s true that some people are more likely to pose a risk on the road due to age or the presence of certain conditions, and state laws often restrict driving and licensing for those groups. Should diabetes be a relevant factor in determining eligibility for a driver’s license? If so, to what extent?

A new American Diabetes Association position statement tackles that very question. In short, the statement favors individual assessments by health care professionals of whether people with diabetes pose a driving risk, as opposed to blanket restrictions based solely on a diagnosis of diabetes. After all, not everyone has the same symptoms or manages the disease in the same way, so why should driving evaluations be one-size-fits-all?

With this position the Association seeks to dispel the misconception that people with diabetes are generally unsafe drivers while helping the field identify high-risk individuals and help them lower their risk for driving mishaps. The primary concern revolves around hypoglycemia (low blood glucose), which can cause a driver to become disoriented. The complications of retinopathy (impacting vision) and peripheral neuropathy (impacting use of foot pedals) may also pose problems.

But as the statement points out, “most people with diabetes safely operate motor vehicles without creating any meaningful risk of injury to themselves or others.”

And there’s solid research to back this up. The risk of someone with diabetes having an accident is only 12 to 19 percent higher than that of the general population. Meanwhile, for example, drivers with attention deficit/hyperactivity disorder are approximately 4 times more likely to have accidents, while those with sleep apnea have a relative risk of about 2.4.

“If society tolerates these conditions,” the statement explains, “it would be unjustified to restrict the driving privileges of a whole class of individuals who are at much lower risk, such as drivers with diabetes.”

No matter what, the Association recommends that drivers at risk for hypoglycemia always test their blood glucose before driving, stock the car with healthy snacks for treating lows and pull over immediately if they ever start to feel low.

This new position statement is part of the annual update of the Association’s Clinical Practice Recommendations, published every January in a supplement to the medical journal Diabetes Care. These standards provide the best possible guidance to health care professionals for diagnosing and treating adults and children with all forms of diabetes and are based on the most current scientific evidence from the international medical and research communities.

The 2012 Clinical Practice Recommendations also include:

Please note: The American Diabetes Association’s Clinical Practice Recommendations make for an interesting read, but they are still geared toward medical professionals. Please consult with your health care team before making any changes to your diabetes management routine.

Daniel Lorber, MD, FACP, CDE
Chair, Diabetes & Driving Workgroup; Member, Professional Practice Committee; and Member, Legal Advocacy Subcommittee, American Diabetes Association

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11 Responses to Driving and Diabetes: Does One Size Fit All?

  1. Laura Daspit says:

    I have type 1 diabetes and I have NEVER had an accident due to diabetes. At all times, I have something in my truck to treat low blood sugar…from Lifesavers to glucose gel to Glucagon kits. I have rarely had to use them. I know when my sugar is dropping and that I need to pull over and treat myself before I get to the point of no return.

    In the state I currently reside, there is an option on the driver’s license application where a person can choose to be designated as an insulin dependent diabetic. I chose this option. Any officer who sees my license will know that I have diabetes. Maybe this is something ALL states should consider. Those of us who have diabetes are not a threat when on the road and should not be treated as such.

    It’s NOT one-size-fits-all. If a person has a history of insulin reaction-related incidents, then I can see where driving privileges should be reduced or revoked. However, in cases of a one time accident, there is no need to raise a fuss. The same type of thing could happen to any person with any type of medical condition. Why pick on diabetics? We certainly didn’t ask for this.

    • I agree. I don’t think diabetics should be singled out as being a higher driving risk. There are people driving with cataracts, sleep deprivation, senility, anger problems and those texting on a cell phone. One group should not be considered riskier than another at any point in time.

  2. shawn says:

    I have this disease,and can tell you i have had three accidents, none my fault.

  3. shanda says:

    well if they want to revoke licenses of people with diabetes whether its low or high then they should have to pay us our income each week. i live with diabetes and i drive to work and home and sometimes on a 2 hours trip and do fine like the other poster said every state should have it somewhere on the license if the person is diabetic or not but not to make us give up our driving thats not fair

  4. patty says:

    I have diabetes and not had a accident or as much as a ticket from this and i love my truck so don’t try to take it a way.

  5. There are many people with chronic conditions which may hamper their ability to drive safely. I agree that health care workers should decide if each patient with diabetes has the capacity to be a safe driver. But, why single out people with diabetes? People with heart disease, emphysema, psychiatric problems etc. all have the potential to have issues while driving that may endanger others. People with any chronic condition should be included and people with diabetes should not be singled out.

  6. Amy says:

    I was diagnosed with Type 1 diabetes a few months ago and would never get behind the wheel if my blood sugar was low. Putting a restriction on my driver’s license is ridiculous!

  7. Kala says:

    I’m a type 2 diabetic and I’ve been driving for 8 years and never had an accident. I don’t think we should be picked on just because we have this medical condition. I can understand maybe having it say on our license that we’re diabetic just in case but to revoke it all together is just wrong. If that’s the case tho then they should revoke a lot of license. I mean think about it a pregnant woman could cause an accident because of a contraction, or someone with asthma could as well if they have an episode. Just think of all the people who can cause accidents who have something wrong or don’t I mean someone could sneeze and cause one. So why pick on us?

  8. CL Harris says:

    Laura has this down perfectly, as does our son! It would be a wonderful thing if ALL drivers were given blood tests prior to receiving licenses, as sadly, there are probably many who do not even know they have this condition! (or other conditions that could be detected via blood testing)

  9. Actually, persons with Type 1 diabetes are probably more trained to be aware of how they feel and react than someone for example who has memory issues and would be more likely to get off the road if they started to not feel well.

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