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.
In the UK it is mandatory under law to check blood sugar before driving if you have Type 1 Diabetes, and every two hours during a long drive. If you have an accident the police can ask you to demonstrate that you tested before you drove using your meter’s memory.
If you cause an accident due to hypoglycaemia you can be charged with “driving under the influence of drugs” since that is technically what you are doing.
I’m surprised if this isn’t the case everywhere but interested to hear how this is managed elsewhere.
I have a friend who lost her driving ability for one year as a result of having a low. Yes it sends chills down my spine.
I started driving before glucose meters were available. I was very fortunate. My car always had glucose available in many different forms, readily available by the driver’s seat. Once personal glucose meters became available I’d check before getting in the car. It just made sense to make sure. It still does.
Kerri- Thanks for bringing attention to this critical issue! And to Dr Ian Blummer for bringing attention to this critical issue in the medical profession.
Driving a car when you are hypoglycemic amounts to operating a several ton weapon of mass destruction. You endanger the public, and yourself. Not to mention your privilege to drive… I have been involved in legal cases where hypoglycemic drivers were being sued for negligence in civil court, or had criminal charges filed for leaving the scene of an accident. I am certain several of my brethren T1D’s died from single car MVA’s while hypoglycemic. There was a tragic case in Pennsylvania some years ago where a hypoglycemic dad passed out in a running car in the garage, so that both he and his young child died of carbon monoxide poisoning. Having had hypoglycemia unawareness myself before CGM, I can imagine might have happened: a sense of overwhelming fatigue hits you, as your brain runs of of fuel, and you think, I just need to close my eyes for a second here…and never wake up.
Enough ! Don’t take chances!
I personally had close calls driving before CGM. Now I always check before and while driving. I have juice boxes in the front dash at all times. I recently put the Siri app on my Dexcom G6 so that I can push the Siri button and ask what my glucose is without having to look- so I can operate my auto more safely. We in the T1D community have a responsibility to never drive while hypoglycemic.
Couldn’t agree more witch checking before and checking often while driving. And always having fast acting within easy reach while driving. I put smarties in my car console when I got it years ago, haven’t needed them. People wanted to toss them as they are sooooo old. What do you know? I needed them on my last trip to visit family. There I am, on the side of the road, munching on super stale smarties. They still worked. And at the next stop? Yep I replaced them.
Yes, this is so important. One great thing is there’s been an update on the iPhone so I can now ask Siri “what is my blood sugar?” and she will tell me out loud – something useful like “it’s 90 and headed slowly down” so that while I’m driving I can check as often as I like without having to look at my phone! I love this new feature.
Excellent topic for any diabeteic to consider(perhaps newer ones haven’t considered it, but I think “light dawns on Marblehead” the longer one lives with and experiences consequences. I don’t recall(I was young, and in the icu for only a week when diagnosed) discussing driving when diagnosed 40 years ago when I got it. 13 years later, and a year later, I experienced two accidents under the influence of low blood sugars. The first around 5am on my way into work, the latter around 6pm on my way back from work(locked my car keys in the construction trailer office, took me an hour to find the spare, ate an apple once I got into the trailer but that was not enough to get to the store(less than a mile)). After the first incident, my first move was to inquire with the motor vehicle registry, which I did and was advised by them that I had “nothing to worry about”.
Anyhow, I agree 100%, check your bs b4 you drive, carry some sort of fast acting sugar source, tablets, juice, chocolate or something, in the car(keep it an insulated lunch box if subjected to melting. Also keep a $5 bill in your wallet in case your body deplenishes the “stashed” source you packed and one needs an emergency stop.
Hi Keri,
I’ve been trying for ages to subscribe, but each time I do so, I do not receive emails from you! Can you help?