Diabetes and driving: evidence and recommendations

In recent years there was an increasing concern about Diabetes and driving. As a result, most countries impose strict rules to diabetic drivers.
Diabetes could impair the ability to driving due to side effects from the treatment (mainly hypoglycaemia) and the potential risk subsequent to complications such as retinopathy or cataract formation impairing vision and neuropathy affecting the ability to feel foot pedals.
The increased crash risk for diabetic patients isn’t fully established. Some studies have reported increased road traffic accident rate while other studies haven´t reported an increased risk. Research studies have demonstrated that hypoglycaemia is a significant factor in impaired driving. As driving performance decline at lower levels of glycaemia, patients’ decisions concerning driving or taking corrective action may also be compromised.
To avoid car crashes patients who are at risk for disruptive hypoglycaemia should be counseled to: carry a blood glucose meter and some sugar source in their vehicle; always measure blood glycaemia before start driving; never begin an extended drive with low normal blood glucose (70- 90 mg/dl) without prophylactic carbohydrate consumption; stop the vehicle as soon any of the symptoms of low blood glucose are experienced, and measure and treat the blood glucose level; not resume driving until their blood glucose and recognition have recovered.
The European Union published in 2009 a directive in order to harmonize rules about driving licensing in member states. As a result, regulations for driving licenses have changed across Europe.
We will revise the evidence on this subject and also driving regulations for patients with diabetes.