Driving

Contents

• Introduction
• Car insurance
• DVLA requirements
• Driving and low blood glucose levels
• Useful resources

Introduction

Having diabetes does not mean you need to give up driving, but it does mean you have to plan things 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 through diet, tablets or insulin therapy. If your company wants to charge you a higher premium, you should get quotes from other companies for comparison, as the cost of car insurance can vary a lot.

DVLA requirements

The DVLA licence categories are as follows:

• Group 1 licence: cars/motorcycles/minibuses (up to eight seats/up to 3.5 tonnes)
• Group 2 licence: large goods vehicles and passenger-carrying vehicles

Drivers treated with insulin 

If you manage your diabetes with insulin therapy you must by law inform the DVLA by completing a DIAB1 form if you have or want to apply for a Group 1 licence. This is decided on a case-by-case basis and if you are approved, your licence will be issued for one, two or three years. There is no fee for renewal. The criteria for approval include the following:

• You have adequate awareness of hypoglycaemia. 
• You have had no more than one severe hypoglycaemic episode (‘hypo’) while awake in which you needed help from another person within the last 12 months, or a period of at least 3 months since your last episode.
• You practise appropriate blood glucose monitoring.
• You have agreed to comply with healthcare professionals’ instructions and report any changes in your conditions to the DVLA.
• You are under regular review.

If you have or want to apply for a Group 2 licence, you need to complete a VDIAB1i form. If you meet all the criteria your licence will be issued and reviewed annually. You should also read leaflet INS186 if you want to apply for vocational entitlement to drive larger vehicles (C1, C1E, D1, DIE, C, CE, D or DE).

For links to the documents mentioned above as well as other relevant information, see the Useful resources section below.

You must tell the DVLA if you have, or develop any problems that may affect your safety to drive. These include the following:

Group 1 drivers

You must by law inform the DVLA if either of these happens:

• Two severe hypoglycaemic episodes (‘hypos’) while awake in which you needed help from another person within the last 12 months
• No longer having warning signs of a hypo, or being unable to recognise these warning signs 

Group 2 drivers

You must by law stop driving Group 2 vehicles and inform the DVLA if either of these happens:

• One hypoglycaemic episode in which you needed help from another person, even if this happened while you were asleep
• No longer having warning signs of a hypo, or being unable to recognise these warning signs 

Both groups of drivers

You must tell the DVLA if any of these occur:

• You have a hypo while driving.
• You have recurrent hypos.
• You develop complications from your diabetes that may interfere with your ability to drive, such as a deterioration in your sight or the inability to bear weight on your foot.

For more information on this, see leaflet INF294.

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

If you have a Group 1 licence you are not obliged to tell the DVLA if your diabetes is managed by diet, tablets or both if you do not have any complications. However it is still best to inform them.

If you hold a Group 2 licence and you take a sulphonylurea or prandial glucose regulator (see Table 1 below) you have an increased risk of hypos. Therefore you must notify the DVLA by completing the DIAB1 form. If you meet medical standards your licence will be issued for one, two or three years. See the Drivers treated with insulin section above.

Table 1: Diabetes tablets

If you are on any other diabetes treatment, including non-insulin injections such as Victoza or Byetta, your medication may not cause hypoglycaemia when taken on its own. However, when used in combination with any of the tablets mentioned above, the risk of hypoglycaemia is greater.

Driving and low blood glucose levels

If your diabetes is treated with insulin or medication that can cause hypoglycaemia, you run the risk of being unsafe on the road and of causing an accident that could be fatal for you or others. It is vital that you do the following:

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 ignition and move into the passenger seat.
• Take slow-acting carbohydrate.
• Ensure that your blood glucose level is above 5 mmol/L for 45 minutes prior to driving again.

To avoid hypoglycaemia, you should make sure you are always prepared by doing the following: 

• If you use fingerprick testing, check your blood glucose level an hour before driving even short distances and every two hours during long journeys.
• Carry fast-acting and slow-acting carbohydrates in your car.
• Never drive for more than two hours without having a snack.
• Carry diabetes identification on your person and in your car.
• Never ignore any symptoms.

Interstitial glucose monitoring systems

Note that in February 2019, the DVLA updated its guidance regarding Flash (FGM) and Continuous Glucose Monitoring (RT-CGM) devices. These can now be used by insulin-dependent drivers to take blood glucose readings. See information below for further details.

Group 1 Drivers

These systems may be used for monitoring glucose at times relevant to driving Group 1 vehicles. Users of these systems must carry fingerprick capillary glucose testing equipment for driving purposes as there are times when a confirmatory fingerprick blood glucose level is required.

If using an interstitial fluid continuous glucose monitoring system (FGM or RT-CGM), the blood glucose level must be confirmed with a fingerprick blood glucose reading in the following circumstances:

• when the glucose level is 4.0 mmol/L or below
• when symptoms of hypoglycaemia are being experienced
• when the glucose monitoring system gives a reading that is not consistent with the symptoms being experienced (eg symptoms of hypoglycaemia and the system reading does not indicate this) - see the INF294 leaflet in Appendix D for further details.

Group 2 Drivers

There is a legal requirement for Group 2 drivers to monitor their blood glucose for the purpose of Group 2 driving.

FGM and RT-CGM interstitial fluid glucose monitoring systems are not permitted for the purposes of Group 2 driving and licensing.

Group 2 drivers who use these devices must continue to monitor fingerprick capillary blood glucose levels with the regularity as defined by the DVLA.

Useful resources

The DVLA website available here is useful reading. Follow the Health and medical conditions link to explore the information available for people with diabetes.

The UK Government has a page on its website here with links to all the necessary documents relating to what you need to tell the DVLA by law, depending on the type of diabetes you have.

There is another page on the same website here with more information on diabetes and driving.

The DIAB1 form can be downloaded here and the VDIAB1i form here.

Leaflet INF294 is available here and leaflet INS186 here.

For details of how to practise good blood glucose monitoring click here.