Click here for summary of DVLA advice

 

Hypoglycaemia

 

In people who are treated with insulin or sulphonylurea drugs, the main potential danger of diabetes and driving is the possibility of hypoglycaemia. In order to avoid hypoglycaemia the following advice should be given:

  • To always carry fast acting and long acting carbohydrate food in the car, e.g. glucose tablets or lucozade (full strength), plain biscuit or piece of fruit.
  • Not to drive for more than 2 hours without checking a blood glucose level.
  • Not to miss or delay a meal or snack.
  • To check blood glucose before and during a journey.
  • If blood glucose level is less than 5mmol/l have a small starchy snack.
  • To carry identification and information on their usual diabetes treatment.

 

If symptoms of hypoglycaemia occur, the following advice should be given:

  • Stop driving as soon as it is safe to do so.
  • Immediately take a glucose drink or glucose tablets
  • Remove the ignition key and move into the passenger seat to avoid any suggestion that the person is in charge of the car.
  • Once hypoglycaemia is resolved then take longer acting carbohydrate, e.g. plain biscuit or piece of fruit.
  • Do not drive for 45 minutes after blood sugars have been corrected. Studies have shown that cognitive function does not recover fully until this time.

 

Drivers with diabetes should know that if they have an accident attributable to hypoglycaemia they render themselves liable to the charge of driving under the influence of drugs.

Completely abstaining from alcohol when driving should be advised.

 

Further information available from Driving and Hypoglycaemia: questions and answers, Association of British Clinical Diabetologists.

 

Car Insurance

 

Diabetes must be disclosed either at the start of a new policy or at the time of diagnosis.  For car insurance to be valid, the person must inform their insurance company as soon as they develop diabetes. This is required whether  treated with a diet only, tablets or insulin. It is always worth shopping around for quotes from a number of insurers, as there can be a big difference in premiums.  Some companies may refuse cover, impose special terms or an increased premium if their statistics show drivers with diabetes to be at a higher risk. If this happens, it is worth advising the person with diabetes to challenge the insurer, especially if their diabetes is well controlled.

 

Diabetes UK services have a motor insurance quote line on Freephone 0800 731 7431. Although these insurers are very sympathetic to people with diabetes, they cannot be guaranteed to be the cheapest in every case.  For further information, contact Diabetes UK Scotland Careline, Tel no: 0141 212 8710, www.diabetes.org.uk

 

Visual Standards

 

Visual standards relating to driving are those applied generally. The person should be able to read a number plate (7.9cm) at a distance of 20.5 metres and have a visual field of a least 120 in the horizontal axis and at least 20 in the vertical axis. This approximates to an equivalent Snellen Chart corrected acuity of 6/12. If in doubt, refer to the Opthalmology Clinic requesting formal assessment.

 

Driving after Instillation of Tropicamide Drops

 

People should be advised not to drive for a minimum of 4 hours afterwards due to a reduction in visual acuity following pupillary dilatation. This advice applies regardless of weather conditions and sunglasses will not improve the situation.

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The Driver and Vehicle Licensing Agency

 

It is the legal responsibility of the person to inform the Driver and Vehicle Licensing Agency (DVLA) when their diabetes is treated with insulin (except in situations where insulin treatment is ‘temporary’ – for less than three months – e.g. /post-myocardial infarction or gestational diabetes).

 

People with diabetes treated with insulin will be sent a ‘DIAB 1’ Form which will ask for further details including the name of their GP or hospital physician and for consent to approach that doctor directly if necessary.

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Cars and Motor Cycles - Group 1 Entitlement

 

For insulin treated people, a licence for 1,2 or 3 years will be issued, which allows the person to drive a vehicle up to 3.5 tonnes. When the licence expires the person will receive a reminder to renew the licence and may also be sent another ‘DIAB 1’ form to complete with more up-to-date information. Renewals will be free of charge. Such drivers must recognise warning symptoms of hypoglycaemia and meet required visual standards

 

As of November 2011, if an individual with diabetes reports more than one episode of severe hypoglycaemia within a 12 month period then the DVLA will apply a driving ban until at least 12 months after the date of the first episode of severe hypoglycaemia i.e. hypoglycaemia requiring the assistance of another person.  No distinction is made between daytime and nocturnal hypoglycaemia.  In addition, individuals must not have impaired hypoglycaemic awareness, defined as "an inability to detect the onset of hypoglycaemia because of a total absence of warning symptoms".

 

People treated with diet, oral hypoglycaemic agents or GLP1 analogue injectable therapy, are not required to notify DVLA - a full "until 70" licence will be issued providing there are no other medical conditions which might prevent this.

 

The person with diabetes must inform the DVLA if any problems or diabetic complications develop which may affect the safety of driving. See details of DVLA Leaflet INF188/2 for specific situations where DVLA must be notified.

 

Guide to Group 2 licence for people with diabetes

 

There are two groups of licence holders and the medical standards differ according to each group:

  • Group 1 includes cars and motorcycles.
  • Group 2 includes large lorries (category C) and buses (category D).

The medical standards for Group 2 are much higher than those for Group 1 because of the size and weight of the vehicle.

If your diabetes is treated by diet alone or diet and tablets or exenatide or liraglutide you may be allowed to hold Group 2 licences, which includes large goods vehicles (LGV) and passenger carrying vehicles (PCV), provided you are otherwise in good health and have passed the relevant driving test.

If your diabetes is treated with insulin you can now undergo individual independent medical assessment annually to assess your fitness to drive these vehicles.

 

Applying or renewing your entitlements to drive categories C1, C1E, D1, D1E, C, CE, D, DE.

In order to apply for this licence, you must ensure that you meet the following qualifying conditions:

  •  No episodes of hypoglycaemia which have required assistance from another person within the last 12 months.
  • You must have full awareness of the symptoms of hypoglycaemia.
  • You must be able to show an understanding of the risks of hypoglycaemia.
  • You must undertake to regularly monitor your blood glucose levels at least twice a day and at times relevant to your driving (no more than 2 hours before the start of the first journey and every 2 hours while driving). More frequent testing may be required if there is a greater risk of hypoglycaemia, for example after physical activity or altered meal routine. This must be done using a blood glucose meter with a memory function and ability to download results. Please contact the Diabetes Specialist Nurses to ensure you have an appropriate blood glucose meter.
  • You must always carry a supply of fast acting carbohydrate within your vehicle.
  • Every 12 months, you will need to be examined by an independent hospital consultant who specialises in diabetes. At the time of this examination, the consultant will need to review your blood glucose results. You must have at least 3 months of downloaded blood glucose readings from a blood glucose meter with a memory function.
  • You must have no other medical condition which would affect your fitness to drive.
  • You will be required to sign an agreement stating that you will comply with the advice of your doctor and report any significant changes in your condition to the DVLA.

There are three stages you need to go through when applying or renewing this licence.

 

First stage- Application forms

You will need:

  • Application form (D2).
  • Medical questionnaire (VDIAB1I).
  • Medical report (D4). You will need to contact the DVLA on 0300 790 6807 or www.direct.gov.uk/motoring to request these forms. This is needed at the first application for the licence and at 5 yearly intervals from the age of 45 until the age of 65, thereafter it is required annually.
  • You are responsible for any fees that may be charged by the doctor for filling in the report.
  • The application form, medical questionnaire and medical report should be sent to the DVLA for assessment before proceeding to the second stage.

 

Second stage- Specialist medical questionnaire

  • The medical questionnaire will be sent to either your own GP or your diabetes consultant (whoever you have seen more recently). You will have to attend an appointment for the form to be completed.
  • At the examination the doctor will need to see 3 months of downloaded blood glucose readings from a blood glucose meter with a memory function.
  • The DVLA will pay for any fee charged for this questionnaire.

 

Third stage- Specialist medical questionnaire and examination by a diabetes consultant

  • The medical questionnaire will be sent to an independent consultant specialising in diabetes. You will have to attend an appointment for this form to be completed.
  • At the examination, the consultant will need to see 3 months of downloaded blood glucose readings from a blood glucose meter with a memory function.
  • The DVLA will pay the fee for this examination.

If you are unsure whether or not you are able to apply for this licence, please contact the DVLA directly:

Phone: 0300 790 6807 (8.30am. to 5.30pm. Mon – Fri)

 

Web site: www.direct.gov.uk/motoring

 

Diabetes Nurses contact numbers

Dundee: 01382 632293

Angus: 01241 447811

Perth: 01738 473476

      

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Taxi Licence

 

Local councils issue licences for taxis and minicabs. Their policies may vary throughout the UK and it is best to check with individual councils for further information.

 

Contacting DVLA

 

People with diabetes who are told by their doctor, specialist or optician to report their condition to DVLA will need to fill in a DIAB1 medical questionnaire about their diabetes.

 

They can download this from www.direct.gov.uk/driverhealth

 

People with any questions about their entitlement to drive or their legal obligations should contact DVLA for advice:

 

Phone DVLA on: 0870 174 7001

Write to: Drivers Medical Group, DVLA,Swansea,SA99 1TU

E-mail: eftd@dvla.gsi.gov.uk

 

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