Drive above five

Driv­ers with di­a­betes need to take ex­tra precautions to avoid de­vel­op­ing hy­po­gly­caemia

Owner Driver - - Diabetes Nsw & Act - Carolien Koren­eff

WHETHER YOU DRIVE for a liv­ing, for plea­sure or merely as a means to get from point A to point B, driv­ing a mo­tor ve­hi­cle is a priv­i­lege that comes with ma­jor per­sonal and le­gal re­spon­si­bil­i­ties. Driv­ing is a com­plex skill, both phys­i­cally and men­tally. Peo­ple with di­a­betes who drive need to take ex­tra precautions. The main dan­ger for those who take in­sulin or glu­cose-low­er­ing med­i­ca­tions is the risk of de­vel­op­ing hy­po­gly­caemia (hypo), when the blood glu­cose level drops be­low 4mmol/L or you de­velop symp­toms – see ta­ble be­low.

How­ever, most hy­pos can be pre­vented by check­ing your blood glu­cose level (BGL) be­fore driv­ing and mak­ing sure that it is above 5mmol/L be­fore you drive.

It is also im­por­tant to check your BGL ev­ery two hours dur­ing driv­ing which can mean stop­ping, pulling over and check­ing your BGL dur­ing the trip. It’s a good idea to then have a snack to pre­vent hy­pos.

Have hypo food avail­able in your ve­hi­cle in the event that your BGL drops be­low five or you de­velop symp­toms of a hypo.

If you sus­pect a hypo while driv­ing, do not de­lay! Pull over safely, and throw your car keys on the seat. By re­mov­ing your keys from the ig­ni­tion you:

1. Avoid driv­ing off while you might be con­fused or dis­ori­en­tated

2. Avoid the car from over­heat­ing and po­ten­tially catch­ing fire, in case you were to lose con­scious­ness.

Have some­thing sweet im­me­di­ately (15-20 grams of glu­cose, like a small juice pop­per) to treat the hypo and fol­low this up with some longer-act­ing car­bo­hy­drate (like a piece of fruit) to avoid a re­lapse.

Stud­ies have shown that your brain func­tion will take at least 30 min­utes to fully re­cover. There­fore, do not re­sume driv­ing for at least 30 min­utes af­ter your BGL is back above five and your hypo symp­toms have com­pletely gone.

If you have had a se­vere hypo in­volv­ing loss of con­scious­ness (in any sit­u­a­tion), do not re­sume driv­ing un­til your di­a­betes spe­cial­ist has checked that you’re safe to do so.

Some peo­ple have few or no symp­toms of a hypo at all. This is often called hypo un­aware­ness and is a se­ri­ous con­di­tion that in­creases the risk of a se­vere or un­con­scious hypo. So it is espe­cially im­por­tant to mon­i­tor your BGL be­fore and reg­u­larly while driv­ing to re­duce the risk of a crash.

Aware­ness of hypo can re­turn in cer­tain cir­cum­stances but, gen­er­ally, if you have had a se­vere or un­con­scious hypo or have hypo un­aware­ness you are not al­lowed to drive un­til you have been cleared to do so by an en­docri­nol­o­gist or di­a­betes spe­cial­ist.

If you use a con­tin­u­ous glu­cose mon­i­tor­ing sys­tem (CGMS), like Dex­com, Guardian Con­nect or Freestyle Li­bre, re­mem­ber that there is about a 10-15 minute de­lay – so con­firm­ing your BGL with a fin­ger prick is the safest way.

A few things to al­ways do be­fore driv­ing a mo­tor ve­hi­cle of any kind are:

• Do not drive if you feel un­well

• Check your BGL be­fore driv­ing and make sure it’s above 5mmol/L be­fore you drive

• Check your blood glu­cose ev­ery two hours dur­ing driv­ing

• Al­ways have fast-act­ing hypo food or a sweet drink (e.g. glu­cose tablets, glu­cose gels, jelly beans or fruit juice pop­pers) and your glu­cose meter in your car when driv­ing

• Be a safe driver; con­sider the safety of your pas­sen­gers, other road users and your­self • Do not de­lay or miss a meal and con­sider a snack when you stop to check your BGL.

OTHER DRIV­ING RE­SPON­SI­BIL­I­TIES

• See your doc­tor and other health­care team mem­bers on a reg­u­lar ba­sis

• High BGLs can cause tired­ness, blurred vi­sion and ef­fect de­ci­sion-mak­ing, which can all im­pact on driv­ing

• Sleep ap­noea is more com­mon in peo­ple liv­ing with type 2 di­a­betes, par­tic­u­larly if over­weight, and can cause ex­treme day­time drowsi­ness and loss of con­cen­tra­tion while driv­ing, so get checked and treated

• Have your eyes checked ev­ery 12 months

• If your feet or legs are numb or painful, or you have trou­ble feel­ing the ped­als when you drive, you should seek ad­vice from your doc­tor or po­di­a­trist promptly. Have your feet checked ev­ery 12 months

• Carry an ID that says you have di­a­betes

• Ad­vise your driv­ing li­cence author­ity that you have di­a­betes

• Make sure both you and your ve­hi­cle have ap­pro­pri­ate in­surance

• Af­ter any sur­gi­cal or med­i­cal pro­ce­dure, seek the ad­vice of your doc­tor to de­ter­mine when you are fit to re­sume driv­ing.

A FEW LAST POINTS

It is your le­gal re­spon­si­bil­ity to ad­vise the driv­ing li­cence author­ity (DLA) in your state or ter­ri­tory if you take glu­cose-low­er­ing med­i­ca­tions, in­clud­ing in­sulin. If you are a com­mer­cial driver, an en­docri­nol­o­gist or di­a­betes spe­cial­ist may need to com­plete a form. Check well ahead of time which records or other ma­te­ri­als you should take to your doc­tor’s ap­point­ment.

For more in­for­ma­tion con­tact the NDSS Helpline on 1300 136 588 or check out the NDSS (www. ndss.com.au) or Di­a­betes NSW & ACT (www.di­a­betesnsw.com.au) web­sites.

“Sleep ap­noea is more com­mon in peo­ple liv­ing with type 2 di­a­betes.”

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