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For most of us, driving represents independence, competence and control. Additionally, many people need to drive for economic reasons: to get to and from work, or as part of their job. But you may have wondered: Can I drive safely with diabetes?
The short answer is “yes.” Most people with diabetes can drive safely as long as they are not affected by complications of the disease, such as severe low blood sugar episodes or vision problems.
The biggest potential driving problems for people with diabetes, in the short-term, are low or high blood sugar episodes.
Low blood sugar—or “hypoglycemia” (also called an “insulin reaction”)—is a blood glucose level that falls below 70 mg/dL. If you take insulin to control your blood sugar or if you are on an oral medication that can cause hypoglycemia (ask your doctor) this is a potential risk for you. When you take too much insulin or diabetes medication and don’t eat enough carbohydrates, your blood sugar can fall too low. The symptoms of low blood sugar resemble those of drunkenness, and include impaired judgment and mental confusion. It's important to check your blood glucose level before getting in the car, especially if you don't always feel the symptoms of hypoglycemia.
On the other hand, blood sugar that is too high also can cause problems for drivers, including blurred vision. So it’s vital to keep your blood sugar in an optimal range while you’re driving. (Before-meal averages should be 90-130 mg/dl; after-meal averages should be less than 180 mg/dl.)
Private, non-commercial driving is an activity that is licensed and controlled by the states and each state has different rules. A summary of each state’s regulations for drivers with diabetes is available online from the American Diabetes Association (ADA). In general, the states don’t prohibit people with diabetes from driving unless you have episodes of loss of consciousness or vision problems. Many DMVs don’t even require you to disclose your diabetes if it is well-controlled.
On the other hand, the federal government regulates licensing of commercial drivers for interstate commerce. Until very recently there was a blanket ban prohibiting anyone with diabetes who used insulin from driving commercial vehicles in interstate commerce. This ban did not apply to those with Type 2 diabetes who did not use insulin. In 2003 a law was passed that opened the possibility of an exemption for people with insulin-treated diabetes, and this law was further liberalized in 2005. It’s still a complicated process. But now, at least, people taking insulin can apply for a commercial driver’s license.
The key to preserving your right to drive for the long-term is the same as preventing the other devastating complications of diabetes: Maintain tight control of your blood sugar levels. Studies show that keeping your blood glucose level at normal or near-normal levels can dramatically reduce your risk of retinopathy, or diabetic blindness. To protect your vision, experts also recommend keeping your blood pressure under control and having a dilated eye exam every year.
If you have to reduce or stop driving, you can still get around. Consider these options:
Lance Porter is the editor of “Diabetes Positive!” magazine and the author of “28 Days to Diabetes Control!”
