Getting in gear: driving with diabetes

Diabetes does not mean you need to give up driving, but it does mean you have to plan in advance so your driving is safe and hazard free.

Car insurance

For your car insurance to be valid you must inform your insurance company as soon as you are diagnosed. This applies whether you control your diabetes by diet, tablets or insulin. If your company wants to charge you a higher premium, get quotes from other companies for comparison, as there can be a big difference.

DVLA

You should check the Government website for guidance about when you need to inform the DVLA about your diabetes.

Licence Categories:

• Group 1 licence: cars/motorcycles/minibuses (up to 8 seats) up to 3.5 tonnes
• Group 2 licence: large goods vehicles and buses and coaches

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Group 1 license restrictions:

Drivers with diabetes treated by non insulin medication, diet, or both.

Group 1 Drivers do not need to tell the DVLA if their diabetes is treated by diet, tablets or both if they are free of complications such as episodes of hypoglycaemia, problems with eyesight or feet.  However it is still best to inform the DVLA. The DVLA have produced a guide with information for drivers with diabetes treated by non-insulin medication, diet or both.

If your condition meets medical standards 1, 2 or 3 year licence will be issued.

The main risk with diabetes and driving relates to the risk of low blood glucose i.e. hypoglycemia or ‘hypo’ which could cause impaired reactions if it occurred during driving. Most non-insulin diabetes treatment, including injections such as Victoza or Byetta, should not cause hypoglycaemia when taken on their own.

However, insulin and sulphonylurea/glinide drugs can cause hypoglycaemia.

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Tablet group	Generic (proper) name	Brand (trade) name
Sulphonylurea	Glibenclamide
	Gliclazide	Diamicron/Diamicron MR
	Glimepiride	Amaryl
	Glipizide	Glibenese/Minodiab
	Tolbutamide
Prandial glucose regulator	Nateglinide	Starlix
	Repaglinide	Prandin

Drivers treated with insulin

If your diabetes is managed with insulin therapy you must by law inform DVLA by completing a Diab 1 form to apply for a Car or Motorcycle licence. In February 2019 the DVLA updated their guidelines for insulin treated diabetes regarding Flash and Continuous Glucose Monitoring (FGM and CGM) devices. These can now be used to take glucose readings by insulin dependent drivers.

Previously drivers using FGMs or CGMs had to check their glucose levels with a finger-prick blood reading no more than two hours before driving and then again on a break after every two hours of driving. The DVLA has produced a guide for driving with insulin-treated diabetes, which includes this updated guidance and you can read it by clicking here.

Your license will be issued for 1, 2 or 3 years. There is no fee for renewal. The following link provides information on driving recommendations for all types of diabetes treatment and other medical conditions.

You must tell the DVLA if you have or develop any problems that affect your safety to drive, such as:

• More than one episode of severe hypoglycaemia, while awake, in the preceding 12 months. Severe hypoglycaemia is defined as requiring the assistance of another person.
• You’ve had a severe hypo whilst driving
• Loss of hypo warning signs
• Recurrent hypos
• Diabetic complications

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Group 2 licence

The following link details the application process for Group 2 Licence and qualifying conditions. If all criteria are met the Licence will be issued and reviewed annually.

If you hold a Group 2 licence and you are prescribed a tablet which is a Sulphonylurea or prandial glucose regulator (see list above) there is an increased risk of hypoglycaemia. Therefore you must notify the DVLA by completing medical questionnaire ‘DIAB1V’.

Whilst insulin treatment used to result in a ban on driving class 2 vehicles, following a change in legislation implemented on the 15/11/11 anyone treated with insulin therapy can now apply for or renew their vocational entitlements to a Group 2 Licence (category C1, C1E, D1,D1E,CE,D,DE), but needs to be able to demonstrate regular glucose monitoring and good diabetes control with good hypoglycaemia awareness.

Driving and low blood glucose

This section is only relevant for people with type 2 diabetes who are being treated with either insulin or other blood-glucose-lowering medication such as sulphonylureas and prandial glucose regulators. 

There is a risk of hypoglycaemia if you are treated with insulin or other medications which carry the risk of hypoglycaemia. Having a hypo while in charge of a motor vehicle can be fatal for you or for others.

At the first sign of hypoglycaemia:

• Stop as soon as it is safe to do so
• Take fast-acting carbohydrate immediately
• Remove the key from the ignition and move into the passenger seat
• Then take slow-acting carbohydrate
• Blood glucose must be above 5 mmol/l for 45 minutes prior to driving again.

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To avoid hypoglycaemia:

• Check blood glucose (using fingertips) before driving (even short distances)
• Check blood glucose during long journeys
• Carry rapid-acting & slow-acting carbohydrates in your car
• Don’t drive for more than 2 hours without a snack
• Carry identification that you have diabetes on yourself and in your car
• Never ignore symptoms of hypoglycaemia

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