My parents made me check my blood sugar before getting behind the wheel when I was a teenager. If I wanted the keys, I had to be responsible without fail, and I had their trust unless I broke the rules.

No exceptions. No excuses.

I started driving in 1995, so my means for blood sugar checks were limited to a glucose meter only. The meter I used at the time had a memory my parents could scroll back and review, so there wasn’t a way to hide my fingersticks … or lackthereof. And even though I was annoyed at times by the extra step required for me to drive, I wanted my independence. I wanted to drive. And when I was a little older, I realized what a big responsibility it is to drive a car.

Fast-forward twenty some odd (very odd) years, checking my blood sugar before I drive is a task that feels like second nature to me, made easier by the advent of continuous glucose monitoring that can provide at-a-glance details on what my blood sugar is doing and where it might be headed.

This morning, my friend Ian Blumer sent me a link to his recent publication, Insulin-Treated Diabetes and Driving: Legal Jeopardy and Consequences of Hypoglycemia, and it’s a tough read. A conclusion quote from the article:

Minimizing risks for hypoglycemia in insulin-treated individuals who operate motor vehicles is of paramount importance. Current medical recommendations are insufficient, patient and provider awareness is poor and current legal mechanisms are ill equipped. We hope this article will generate discussion among health-care providers, people living with insulin-treated diabetes and legislators, with the common goal of improving driving safety and avoiding future harm.

Insulin-Treated Diabetes and Driving: Legal Jeopardy and Consequences of Hypoglycemia

Tips for new (and even established) drivers?

  • Always check before driving
  • If you can access a continuous glucose monitor, wear it 24/7 and check it before driving (and throughout long drives).
  • Keep sources of fast-acting glucose in your car at all times (glucose tabs are great for this, as they don’t melt or freeze)
  • Wear a medical alert bracelet (or some kind of medical disclosure)
  • Don’t text while driving (this is not diabetes-related, but c’mon … don’t text while driving)

There’s a lot at stake when anyone gets behind the wheel, and adding diabetes to the equation makes for an even more tangled narrative. But talking about these things, and finding strategies for avoiding scary circumstances, is important. In my opinion, driving under the influence of a low blood sugar is extremely dangerous, but I truly feel that using a CGM has made me a safer driver. I’m grateful that a CGM is part of my standard of care.