Insulin dependent diabetes mellitus and driving

Insulin-treated diabetes

Group 1:

• Must meet the criteria to drive and must notify the DVLA. All the following criteria must be met for the DVLA to license the person with insulin-treated diabetes for 1, 2 or 3 years
  • adequate awareness of hypoglycaemia
  • no more than 1 episode of severe hypoglycaemia while awake in the preceding 12 months and the most recent episode occurred more than 3 months ago (see recurrent severe hypoglycaemia guidance below)
  • practises appropriate glucose monitoring as defined in the box below
  • not regarded as a likely risk to the public while driving
  • meets the visual standards for acuity and visual field
  • under regular review

Group 1 requirements for insulin-treated drivers licensed on review

• Group 1
  • glucose testing no more than 2 hours before the start of the first journey and
  • every 2 hours after driving has started
  • a maximum of 2 hours should pass between the pre-driving glucose test and the first glucose check performed after driving has started
  • applicants will be asked to sign an undertaking to comply with the directions of the healthcare professionals treating their diabetes and to report any significant change in their condition to the DVLA immediately.
  • more frequent self-monitoring may be required with any greater risk of hypoglycaemia (physical activity, altered meal routine)

Temporary insulin treatment - including gestational diabetes or post-myocardial infarction

• Group 1
  • May drive and need not notify the DVLA, provided:
    • under medical supervision
    • not advised by clinician as at risk of disabling hypoglycaemia
  • May continue to drive but must notify the DVLA if:
    • disabling hypoglycaemia occurs
    • treatment continues for more than 3 months - or in gestational diabetes, continues for 3 months after delivery

Impaired awareness of hypoglycaemia

Impaired awareness of hypoglycaemia for Group 1 drivers is defined as 'an inability to detect the onset of hypoglycaemia because of total absence of warning symptoms'

Group 2 drivers must have full awareness of hypoglycaemia.

Severe hypoglycaemia

The law defines 'severe' as an episode of hypoglycaemia requiring the assistance of another person.

Group 1 drivers - episodes of hypoglycaemia occurring during established sleep are no longer considered relevant for licensing purposes unless there are concerns regarding their hypoglycaemia awareness.

Group 2 drivers - must report all episodes of severe hypoglycaemia requiring the assistance of another person. For more details and most up to date guidance then this may be obtained from the publication "At a Glance Guide to the Current Medical Standards of Fitness to Drive" and the website www.dvla.gov.uk.

For more details and most up to date guidance then this should be obtained from the publication "At a Glance Guide to the Current Medical Standards of Fitness to Drive" and the website www.dvla.gov.uk.

Reference:

• (1) DVLA (March 2019). At a glance guide to the current medical standards of fitness to drive