When is it safe to drive with type 1 diabetes?

April 21, 2017 by Serena Gordon, Healthday Reporter

(HealthDay)—Having type 1 diabetes can raise your chances of crashing while driving, but new research offers a checklist that helps determine whether it is safe for you to get behind the wheel.

The wrong amounts of insulin and other -lowering medications can trigger dangerously low , which can cause people to pass out or have seizures, the researchers explained.

"People with need to recognize that they're part of a huge mass of people who have potentially impaired driving, like people with heart disease or narcolepsy. They shouldn't think of themselves as isolated. It's just an issue to deal with," said the author of a new study on diabetes and driving, Daniel Cox. He's a professor in psychiatry, internal medicine and ophthalmology at the University of Virginia Health System in Charlottesville.

"By no means are we saying that people with type 1 diabetes shouldn't drive. But, just like pilots go through a pre-flight checklist, drivers with type 1 diabetes need to go through a pre-drive checklist," he suggested.

Cox explained that some people with diabetes have a higher-than-average risk of driving troubles. This includes people who've already had a serious low blood sugar event (hypoglycemia) while driving, people who mismanage hypoglycemia, people who drive a lot, and people with diabetes who've lost feeling in their feet or legs (diabetic neuropathy), because they can't feel the pedals.

But doctors don't have a standardized assessment to determine who's at high risk for a diabetes-related accident and who's not.

So, Cox and his colleagues developed an 11-question test called the Risk Assessment of Diabetic Drivers (RADD). The researchers administered the test to more than 500 drivers with type 1 diabetes from Boston, central Virginia and Minneapolis.

The investigators asked the study participants about their driving "mishaps." A driving mishap—as defined by this study—was a dangerous driving situation that resulted in an accident or could have resulted in an accident.

The assessment accurately identified 61 percent of those who were at high risk for having driving issues, and 75 percent of those who were at low risk of having driving problems.

The second part of the study included almost 500 drivers with type 1 diabetes from across the country who took the RADD test online. The study found that 372 were identified as high-risk and 118 were considered low-risk.

Half of these people were then given routine care, and the rest were asked to participate in an online intervention.

The intervention aimed to anticipate, prevent, detect and treat hypoglycemia. All of the intervention participants were given a toolkit for their car. It contained a blood sugar meter, a pre-drive checklist, a key chain with a stoplight symbol to remind drivers to stop and treat their if their reading was below 70 milligrams per deciliter (mg/dL), or to be cautious and eat some foods containing carbohydrates before driving if it was between 70 and 90. (Below 70 is considered hypoglycemia.) Over 90 mg/dL is considered a green light, Cox said.

The kits also contained a fast-acting glucose product, such as glucose tablets or gel.

"Many people with type 1 diabetes didn't know how to properly treat hypoglycemia. They eat something with a lot of fat or protein, and that doesn't make blood glucose rise quickly. If you want a fast rise in blood glucose, glucose tablets will do it," Cox explained.

He said people with type 1 diabetes should always have fast-acting carbohydrates in their car.

The study found that the intervention tool helped drivers avoid hypoglycemia while driving.

Dr. Joel Zonszein is director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

Zonszein said he was glad to see the study bringing attention to the issue. "It reminds us that people with diabetes should be assessed individually, taking into account each individual's medical history as well as the potential related risks associated with driving, as recommended by the American Diabetes Association," he said.

But, he added that "the patients at risk are few, and they are mainly limited to older individuals, and those with advanced complications and type 1 diabetes."

Zonszein said he'd rather that and their driving abilities were assessed by their physician or a certified diabetes educator instead of an online program.

Dr. Minisha Sood, an endocrinologist from Lenox Hill Hospital in New York City, agreed that it's important to have a doctor or diabetes educator involved in the process.

"The anonymity [of an internet screening] may be a draw for patients who might feel embarrassed or anxious about their potential risk. It would be important for a care provider to have access to the assessment results, however, in order to keep a patient out of harm's way," she said.

Sood also agreed that anyone with "diabetes should always keep a fast-acting carbohydrate or source of glucose in the car for emergencies."

The study was published online recently in the journal Diabetes Care.

Explore further: Low blood glucose levels in hospitalized patients linked to increased mortality risk

More information: Daniel Cox, Ph.D., A.H.P.P., professor, departments of psychiatry, internal medicine, and ophthalmology, and director, Center for Behavioral Medicine Research and Virginia Driving Safety Laboratories, University of Virginia Health System, Charlottesville, Va.; Minisha Sood, M.D., endocrinologist, Lenox Hill Hospital, New York City; Joel Zonszein, M.D., director, Clinical Diabetes Center, Montefiore Medical Center, New York City; April 13, 2017, Diabetes Care, online

To read more about diabetes and driving, visit the American Diabetes Association.

Related Stories

Low blood glucose levels in hospitalized patients linked to increased mortality risk

November 17, 2016
In hospitalized patients, low blood sugar—also known as hypoglycemia—is associated with increased short- and long-term mortality risk, according to a new study published in the Endocrine Society's Journal of Clinical ...

Severe hypoglycemia linked to increased risk of death in people with diabetes

March 10, 2017
A single instance of blood sugar falling so low as to require an emergency department visit was associated with nearly double the risk of cardiovascular disease or death, finds a new Johns Hopkins Bloomberg School of Public ...

Risks of diabetics fasting during Ramadan: Hypoglycemia rates with insulin pump v. injections

April 7, 2017
A new study examining the risk of fasting during Ramadan for people with type 1 diabetes compared blood glucose control and the rates of hypoglycemia and hyperglycemia between users of insulin pump therapy versus multiple ...

FDA OKs new injectable type 2 diabetes medication

July 28, 2016
(HealthDay)—The injectable drug Adlyxin (lixisenatide) has been approved to treat adults with type 2 diabetes, the U.S. Food and Drug Administration says.

Lowest glucose variability for insulin + GLP-1 RA in T2DM

December 20, 2016
(HealthDay)—For patients with type 2 diabetes, the lowest glucose variability (GV) and hypoglycemia is seen for patients using basal insulin + glucagon-like peptide 1 receptor agonist (GLP-1 RA) (BGLP), according to a study ...

Recommended for you

Personalized blood sugar goals can save diabetes patients thousands

December 11, 2017
A cost analysis by researchers at the University of Chicago Medicine shows treatment plans that set individualized blood sugar goals for diabetes patients, tailored to their age and health history, can save $13,546 in health ...

Kidney disease increases risk of diabetes, study shows

December 11, 2017
Diabetes is known to increase a person's risk of kidney disease. Now, a new study from Washington University School of Medicine in St. Louis suggests that the converse also is true: Kidney dysfunction increases the risk of ...

Type 2 diabetes is not for life

December 5, 2017
Almost half of the patients with Type 2 diabetes supported by their GPs on a weight loss programme were able to reverse their diabetes in a year, a study has found.

Skipping breakfast disrupts 'clock genes' that regulate body weight

November 30, 2017
Irregular eating habits such as skipping breakfast are often associated with obesity, type 2 diabetes, hypertension and cardiovascular disease, but the precise impact of meal times on the body's internal clock has been less ...

Type 2 diabetes has hepatic origins

November 28, 2017
Affecting as many as 650 million people worldwide, obesity has become one of the most serious global health issues. Among its detrimental effects, it increases the risk of developing metabolic conditions, and primarily type ...

Critical link between obesity and diabetes has been identified

November 28, 2017
UT Southwestern researchers have identified a major mechanism by which obesity causes type 2 diabetes, which is a common complication of being overweight that afflicts more than 30 million Americans and over 400 million ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

margarett6
not rated yet Apr 21, 2017
I was diagnosed with type 2 Diabetes and put on Metformin on June 26th, 2016. I started the ADA diet and followed it 100% for a few weeks and could not get my blood sugar to go below 140. Finally i began to panic and called my doctor, he told me to get used to it. He said I would be on metformin my whole life and eventually insulin. At that point i knew something wasn't right and began to do a lot of research. Then I found Lisa's diabetes story (google " HOW EVER I FREED MYSELF FROM THE DIABETES " ) I read that article from end to end because everything the writer was saying made absolute sense. I started the diet that day and the next morning my blood sugar was down to 100 and now i have a fasting blood sugar between Mid 70's and the 80's. My doctor took me off the metformin after just three week of being on this lifestyle change. I have lost over 30 pounds and 6+ inches around my waist in a month. The truth is we can get off the drugs and help myself by trying natural methods

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.