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Diabetics and driving safety

How to stay safe on the road for drivers with diabetes

Nearly 30 million Americans have diabetes, and that number continues to rise. In light of how common it is, driving regulations have been made to make sure those with diabetes aren’t facing unfair hurdles for driving and getting car insurance. You can keep your license if you’re diagnosed with diabetes, but you do have some extra requirements and precautions to protect yourself and other drivers.

How diabetes affects driving

The two main concerns with diabetes are the chances of a severe hypoglycemic event while driving and the impact it can have on the rest of your body. For this reason, there are special conditions in place for driving with diabetes. If you don’t meet them, you are not legally able to drive and your car insurance probably won’t cover you in the event of an accident.

Some of the symptoms of diabetes that could affect your ability to drive include:

  • Loss of consciousness
  • Low blood sugar
  • Seizures
  • Foot problems
  • Vision problems

How to get your driver’s license with diabetes

There are four main things to do before you can legally drive with diabetes.

  • You must get assessed for chances of a severe hypoglycemic event.
  • You must meet the licensing requirements for driving with diabetes.
  • You must have any diabetes comorbidities assessed.
  • You must take special precautions before driving.

1. Get assessed for chances of a severe hypoglycemic event

You should not drive following a severe hypoglycemic event until an endocrinologist or a physician specializing in diabetes has cleared you to drive. A severe episode is one where you are unable to treat yourself and where you require outside assistance.

You generally won’t be able to drive for at least six weeks following a severe hypoglycemic episode, but it may be longer depending on your license type, the reason for the episode and the specialist’s opinion.

Generally, you will be cleared to drive again when the specialist gives their approval in line with the following:

  • The steps you are taking to manage your condition.
  • The chances of your experiencing a hypoglycemic episode without any early warning signs.
  • The overall chances of you experiencing future severe hypoglycemic episodes.

2. Review licensing requirements for driving with diabetes

These requirements can vary depending on how you are managing the condition and whether you’re going for a commercial or personal driver’s license. In all cases, you must follow the severe hypoglycemic event and comorbidity requirements.

If your diabetes is managed by diet and exercise, you’ll need to inform the DMV and possibly fill out a form it. This is the same for both commercial and private driver’s licenses.

If your diabetes is treated with glucose-lowering agents or insulin, you should consult your local licensing authority because regulations and restrictions vary by state.

3. Get an assessment of comorbidities

Any diabetes-related health issues that may impact your ability to drive will need to be separately assessed. To meet this requirement, you need to have periodic check-ups with a medical practitioner.

These check-ups may specifically include, but are not limited to, the following:

  • Vision testing. Annual eye tests are necessary. You should have a retinal screening done every two years, or more frequently if you show signs of being especially at risk.
  • Neuropathy and foot care. The severity of the condition needs to be assessed in line with how it might affect your ability to drive. Specifically, you need to demonstrate adequate sensation and movement to operate the foot pedals.
  • Sleep apnea. This is a common comorbidity with diabetes, and evidence has shown that people with sleep apnea are much more likely to have car accidents. This is assessed specifically in line with your personal risk factors, such as your BMI and your score on tests like the Epworth Sleepiness Scale. This test determines how likely you are to doze off in certain situations like being stuck in traffic.
  • Heart issues. There are no specific guidelines for assessing one’s risk of cardiovascular issues in relation to diabetes or one’s ability to drive, but you will generally need regular assessments to determine your risk of a heart condition.

4. Follow precautions you need to take

Before you’re legally able to drive, you should have completed the following:

  • Obtained identification that says you are diabetic
  • Informed your licensing authority that you have diabetes
  • Had your feet and eyes checked in the last 12 months
  • Ensured you have no untreated daytime drowsiness or sleep apnea

Before driving, you should do the following:

  • Check your blood glucose levels. It should be above 80mg/dl before you get behind the wheel.
  • Have access to a fast-acting carbohydrate while driving, such as jelly beans, fruit juice or a soft drink.
  • Take your blood glucose meter with you while driving.
  • While driving, check your blood glucose level at least every two hours.

What’s a safe blood sugar level for driving?

Diabetic drivers performed significantly worse on a road test when mildly hypoglycemic, at blood sugar levels between 70 to 50 mg/dl, according to a study by the American Diabetes Association. Most diabetics have a target blood sugar level between 80 to 180 mg/dl, with a range of 80 to 130 most of the day. If your blood sugar is higher or lower than your target range, get advice from your doctor before getting behind the wheel.

Can I get car insurance if I have diabetes?

By following the appropriate licensing steps, as well as by informing your car insurance provider, you are fulfilling your requirements and can get the benefits of car insurance with minimal impact to your premiums or coverage.

If your diabetes requires you to have a conditional driver’s license, this may include restrictions around where and when you can drive. If this is the case, you might want to look into pay-as-you-go car insurance policies if you aren’t driving as much as you used to.

What should I watch out for?

If you aren’t driving legally, such as if you’ve recently had a severe hypoglycemic episode and the future risk of another episode has yet to be determined, you generally cannot expect your car insurance to cover you.

With car insurance, you have an obligation to inform your insurer of anything that may affect your ability to drive, which includes diabetes. If you do not let your insurer know, then you might be breaching the terms of your car insurance policy, and they may be able to decline your claim regardless of whether it has anything to do with diabetes or whether you were at fault.

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Diabetic driving license restrictions

Each state has different laws about how diabetics can keep their driver’s licenses. For example, in the state of New York, drivers must prove they have not suffered a loss of consciousness in the last 12 months. In Texas, drivers must prove they haven’t fainted, had a stroke or caused an accident.

Many states have similar laws. The main thing each law has in common is proving that you’re safe to drive and that you have your diabetes under control. Sometimes you’ll also need medical proof as well, like a note from your doctor explaining any new medication or the cause of any diabetic episode.

Can diabetics lose their driving license?

Yes, you can lose your driver’s license if the DMV thinks you present a danger to others on the road due to your medical condition. If you’ve had a seizure, epileptic shock or hypoglycemic episode while driving, your driver’s license might be suspended.

My diabetic driving license was revoked, what should I do?

Typically your license wouldn’t be suspended until you have a chance to defend yourself.

If your license is suspended or you applied for a license and you’re denied, you can appeal to your state DMV. You’ll usually have to submit your evidence in a hearing and/or retake your road test.

Can I drive if I lose a limb?

Yes, many amputees can drive a car, depending on the nature of the amputation and prosthetics. You might need special car modifications to safely drive, and are typically additional steps to maintain your driver’s license. Most diabetics who lose a foot switch to using their other leg for the gas and brake pedals.

In a study by the PMR Journal, getting a leg or foot amputation presented challenges with driving, but not ones that couldn’t be overcome.

80% of amputees returned to driving within 4 months of their surgery. 16% of amputees needed car modifications to continue driving, and most switched to an automatic transmission. The study also found it’s a lot easier to get back behind the wheel if you lose your left foot instead of a right foot. 40% of right-side amputees required car modifications, and they were 25% more likely to stop driving altogether.

Several were asked to retake their driving test to get licensed, and few had difficulties passing. Only 2% of participants had any issues getting insurance.

Amputee driving laws

  • Notify the DMV of any new medical conditions if your doctor hasn’t already.
  • Get a medical form from your doctor if it’s required by law.
  • Follow any requirements for car modifications needed for you to drive.
  • Get retested for your license if your DMV requires it.
  • Your prosthesis is treated like an eyeglasses restriction on your license. Wear your prosthesis during your road test and every time you drive if it’s necessary for you to drive. If you don’t need the prosthesis or may occasionally drive without it, don’t use it on the test to avoid having the restriction on your license.
  • Follow any other requirements for drivers with disabilities according to your state laws.

Bottom line

Diabetes can have a significant impact on your ability to drive safely, but by taking the right steps you can help minimize the risk and make sure you still have a wide range of car insurance options available.

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