I’ve done a few posts about diabetes and driving over the years. It’s a really tricky one, this topic. On the one hand I totally agree with the medical professional who taught me “Five before you drive” (as in 5mmol/l), but in reality this is not achieveable all the time, and there are going to be times when you get behind the wheel when your blood sugar is lower than that; or if you’re driving a longer distance you can have your BG plummet while you’re on the road.
This is why I was so sad when I read this article about a diabetic man who lost consciousness at the wheel and ran over and killed a woman in his neighbourhood. He’s been charged with manslaughter. There are no winners in this situation – everybody involved came out of it a loser. I feel very sorry for the man who was driving, and the family who lost someone they loved. Made all the more awful by legal wrangling. I don’t know what the solution is… this happened in the States where access to CGMS is a lot more available, but still not a given for everyone – it almost seems like we should all be issued with a CGMS which we can program to alarm if our sugars drop below a safe level. Not going to happen though, is it?
Posted in CGMS, Monitoring
Tagged as driving
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Saffy wrote
The boffins would say the cost-benefit analysis didn’t favour it me thinks
Poor people. I am the world’s most pedantic long distance driver – stopping every 1/2 hour to check my BG.
Aaron wrote
That is awful. I can’t even imagine how it would feel. I remember doing a test before dinner when I was about 16 once and being utterly astonished that I was 1.8mmol/L – I had no symptoms that I could discern AT ALL.
It makes you wonder though doesn’t it, are they going to apply the same charges to someone that has a heart attack if they are at a known risk in similar circumstances? The legal precedence for this case will be interesting.
Dee wrote
I’ve had a couple of lows while driving – both times have been fast drops – once because I was doing a business trip and forgot to eat all my breakfast! I had a guy from work with me, and he didn’t realise anything was fine until we stopped to get petrol – and I parked the car somewhat strangely – apparently my driving was fine – and I’d dropped from a 6 to a 1.6 in just over 35 minutes – I got hell hypo signs when my bg was on it’s way back up.
I’ve done a lot of solo driving from Wellington to Auckland over the years – I know it takes longer to go up SH 1, but with all the small towns there is always somewhere to stop and test every 30-45 min or so. I have in my car a plastic container with a pack of jelly beans, a box of museli bars and a pack of spare test strips and some pen needles in it, just as back up. If I’m going a long way there is usually a sleeping bag in the car as well, and normally I have a water bottle too. (I often have a sleeping bag in the car if I’m going through the desert road in anywere from autumn to summer time in case of snow falls!) I have the sleeping bag as I often get cold after a hypo and if I am driving long distances (ie palmy north to auckland/welly to auckland) I have found that I am better to curl up and snoooze or read for 15-20 minutes while waiting to re check if I hit a 3 on a long drive, rather than get frustrated at waiting!
Roy wrote
We don’t really have the words to express the pain and sorrow these events bring with them. I have had three driving accdents in thirty-nine years as a result of low BG. One in 1976, one in 2003 and another in 2005, no other vehicles were involved, but I did have family with me on two occasions and was alone for the other, this one was caused by being low and not noticing it and more importantly, I didn’t check before driving, which I have done since starting fast acting insulin. The two others were related to change of insulin, but I added more than one additional portion of stupidity to the second event, which agravated it and I would not offer these as any excuse.
I have; however, been undergoing scrutiny for being fit to drive for the past eighteen months and I have commented on aspects of it in relation A1c levels posted at times. This came about simply because after switching to Lantus the registar suggested they could fine tune my control to even out the lows and highs, I didn’t believe them as many have tried but no one has ever succeded and I said yes.
My A1c was 6.1 (43m/mol), but I resisted lowering my insulin and raising the A1c level to the suggested standard of 7 (53 m/mol), and it all turned very quickly into a not fit to drive situation defined as “The popensary possibility of hypoglycemic event” It was eather lift it or have the licence cancelled. It was here I also discoverd that if you have more than one low BG (3.2) per 31 or 32 days you are not fit to drive and the stand down time for a low BG is 5 hours minumin.
I am now 7 (53), and my meter averages show 8.8 m/mol for two weeks and 8.7 for four weeks, seems okay.
I could be paranoied, but my concern is that because the damage I have already inflicted on my eyes were caused elevated BG levels that you must get to have averages llike this, I can not see how the eyes will not be affected, yet I am told they will most likely be okay, Hmm? While my heart goes out to this guy, the rules are simple and if I might say, Saffy correctly simple, check!
Penny wrote
I echo people above with my thoughts going to the man in this situation. It is something I fear. I only recently learnt the five before you drive, but have always known that if I have an accident when low I could be charged with driving under the influence of drugs – crazy I know but apparently the case. That is without anyone else being involved. I have had periods when i have been banned from driving.
However we have a responsibility as drivers to ensure that we are safe – more for the safety of others than of ourselves. A car is a potentially dangerous vehicle. Nothing in life is so urgent it won’t wait half an hour or longer whilst we ensure we are safe to drive and it may save someones life.
The general rules I think that everyone should go by are not to drive when you are due to eat, to test your blood sugar before you drive and regularly during the drive (at least every hour, but more often if you have a habit of dropping rapidly), not to drive immediately following a hypo, not to drive after a bolus of insuliln for a high.
Roy who told you about not being fit to drive if you have more tha one hypo in every 31 days? That seems very far fetched. Most of us would never be able to drive if that was the case.
Roy wrote
Hi Penny. I agree. I was shown it by a medical person, but when I tried to find it myself in the driving law for Diabetes I was not able to locate it. I understand the system is strike three over 31 or 32 days and after the third hypo you can’t drive.
Doctors can recommend you stop driving if you are having lows and if you are unaware of them, which I assume comes under the possibility of a hypoglycemic event thing.
Colin wrote
The last time that I had a hypo while driving, in 2000, the wife told my D Specialist and she told me in no uncertain terms that she was required to get my licence removed if I didn’t get better control. According to what I understand she said to me, I must test before and while driving, and eat if lower than 6.
Because my HbA1c was 6.1 at the time, and my daytime BG showed that it should be higher, she knew that I had hypo-unawareness and so must have been having nighttime hypos.
Now that my HbA1c is cruising along at about 8.5 I can feel most of the hypos, so are hugely safer on the road.