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:
- A new section and table on common co-morbidities (other medical conditions more common in people with diabetes), such as sleep apnea and hearing impairment.
- A new table listing the advantages and disadvantages of noninsulin therapies for hyperglycemia (high blood glucose) in patients with type 2 diabetes.
- A revised position statement on managing diabetes at camps for children with diabetes.
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