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Official DVLA guidelines for insulin/driving

Discussion in 'Driving and DVLA' started by diamondnostril, Nov 24, 2016.

  1. diamondnostril

    diamondnostril Type 1 · Well-Known Member

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    Hello,

    Is anybody able to provide a link to an official and up-to-date set of guidelines from the DVLA for drivers on Insulin?

    I've been searching on the gov.uk site today and cannot find such a thing. I found the instructions what to do to inform the DVLA that you have diabetes, and instructions for how to fill out the DIAB1 form etc etc. But what I'm missing is the official DVLA guidelines on what you must do for each time you drive.

    I've found several leaflets and printouts from Diabetes and Healthcare organisations which state their guidelines, but these do not constitute the official word from DVLA. I'm thinking that there must be an official document - can anyone point me to it?

    Thanks in advance :)
    Antony
     
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  2. GrantGam

    GrantGam Type 1 · Well-Known Member

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    #2 GrantGam, Nov 24, 2016 at 5:40 AM
    Last edited: Nov 24, 2016
  3. CapnGrumpy

    CapnGrumpy Type 1 · Well-Known Member

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  4. GrantGam

    GrantGam Type 1 · Well-Known Member

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    @diamondnostril, @CapnGrumpy - I'll admit that I cannot find anything written by the DVLA that says "5mmol/l before you drive", or that anything <4mmol/l means a hypo...

    EDIT to add - I've emailed the DVLA asking them to provide a source of the aforementioned information, not from a 3rd party. Should hear back within 3 working days:)
     
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    #4 GrantGam, Nov 24, 2016 at 6:05 AM
    Last edited: Nov 24, 2016
  5. CapnGrumpy

    CapnGrumpy Type 1 · Well-Known Member

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    @GrantGam1337 I've never seen any bs numbers officially given by DVLA either - just references to hypoglycaemia or severe hypoglycaemia. Perhaps they consider that to be a medical definition and therefore outside their scope.
     
  6. tim2000s

    tim2000s Type 1 · Moderator
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    There is a single PDF sheet that provides guidance. I've only ever found it on the web and never seen it in the official documents, but it is an official doc. Let me see if I can dig it out.
     
  7. iHs

    iHs · Well-Known Member

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    I think its on the other DSF website - Patti D Evans.
     
  8. tim2000s

    tim2000s Type 1 · Moderator
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    I think the DVLA has re-arranged their website. My old links are broken.
     
  9. slip

    slip Type 1 · Well-Known Member

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    if I remember rightly - on the form you sign it says 5 to drive, 4-5 take carbs, under 4 take a taxi..........:rolleyes: or words to that affect!
     
  10. iHs

    iHs · Well-Known Member

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    I am about to renew my licence and looking closely at the forms, there is no mention of a safe bg level....only a box to sign that bg levels will be checked within 2hrs of commencing the first journey and then every 2hrs while driving
     
  11. GrantGam

    GrantGam Type 1 · Well-Known Member

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    I think the DVLA site is broken, and your links have been re-arranged... :)
     
  12. GrantGam

    GrantGam Type 1 · Well-Known Member

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    Here is my reply from the DVLA... I'm afraid I cannot provide my initial inquiry, as it was submitted in a form on their website. But I specifically asked for:

    -A DVLA published document (not from a 3rd party) outlining the figures they wanted (in mmol/l) to deem a diabetic fit to drive:

    "Dear Mr Gammie




    Thank you for your email received on 24/11/16. Your email reference number is ________.





    For assistance regarding this matter you can view the 'Accessing Fitness to Drive' guide, which will outline the current medical standards to hold a driving licence.





    The guide can be viewed and downloaded at - https://www.gov.uk/guidance/assessing-fitness-to-drive-a-guide-for-medical-professionals





    The document is created for doctors to refer to when advising people on driving. If you would like further assistance regarding the current medical standards we would advise to discuss this with your doctor.
    "

    About as much use as an ashtray on a motorbike? It would seem that the DVLA don't actually directly specify medical standards (BG upper/lower limits or cut offs that would deem us fit to drive); and it's ultimately a collective decision from a health body. Still, it would make a lot of sense to have this information displayed on their website...
     
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    #12 GrantGam, Nov 24, 2016 at 11:42 AM
    Last edited: Nov 24, 2016
  13. azure

    azure Type 1 · Expert

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    Perhaps they feel that one number would be too broad a guidance? They may be relying on HCPs to give individual advice.

    Personally, I like to be 6+ to drive, even if I'm only driving for a short time. I see 5 as the minimum, so being a little above that gives me leeway.
     
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  14. GrantGam

    GrantGam Type 1 · Well-Known Member

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    Personally, I'm more concerned why they don't have somewhere on their website - a statement like "don't drive <4mmol/l" or "maintain a minimum glucose of 5mmol/l to drive in the UK". What do you think?

    I also like to be at least 6mmol/l, it's just routine to take a "safety swig" of my passenger lucozade even after I've tested fine for driving. Daft habit I guess... :)
     
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  15. azure

    azure Type 1 · Expert

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    I tend to agree @GrantGam1337 You'd think it would be obvious but having read some comments online, it's obviously not to some people.

    But again, maybe they consider that constitutes medical advice? Or it could be they don't want to be held liable should an accident occur? That is, someone tested at 5.1' drove but then had a hypo, they could claim they weren't at fault as they were "doing what the DVLA said".

    My bigger concern is that they say to test within two hours before you drive. I'd change that to just before you get in the car. I'd also up the recommended frequency of blood tests.
     
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  16. Oldvatr

    Oldvatr Type 2 · Well-Known Member

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    DVLA seem to have woken up to the fact that 'one size does NOT fit all' The guide of 5 mmol/l is only an advisory at best and was never mandatory. It is set higher than the hypo upper band limit of 3,9 mmol/l simply to allow for inaccuracies in taking a reading, which could be +/- 1 mmol/l Today that error allowance is 0,8 mmol/l (15%), but it is only a suggestion since I personally have experienced a drop from 7 mmol/l down to 2.1 within an hour of eating a meal, and I am not on insulin,,,,,,,

    Even now, I use 2 meters in parallel, and I can have a hypo event with one meter reading around 3.2, but the other reading around 6. Since I have no way of proving either meter as faulty, I can only rely on my symptoms to guide me, Now that my body is keto enabled, I am more resiliant in my hypo's so can go lower than I used to. But I still aim for 5 on the lower reading meter as my target for driving.

    Instead, the DVLA has made the declaration of taking care to avoid hypo's on each driver as the mandatory requirement and there is a further requirement put on us to report any hypo event that required third party intervention (e.g. paramedics). There is a further move to place this onus on medical staff to report such events as a statuatory requirement in the NHS, but that is not yet in place.
     
  17. noblehead

    noblehead Type 1 · Guru
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    I quite agree, seems odd that they don't.

    Much like yourself and @azure I prefer to be around 6mmol/l on long car journeys.
     
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  18. iHs

    iHs · Well-Known Member

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    I think if I remember correctly, the last time my licence was renewed, the guidance on safe bg levels and driving was enclosed when my new licence arrived but it could have been typed out using large bold text to make it stand out a bit more but sadly wasn't. Will have to see if the guidance is a bit more prominent this time around..

    My advice is to definately test bg before driving, examine the IOB left to run and make sure that some easy reach source of glucose is at hand that can be eaten first while looking for somewhere to pull over. Ideally, use cgm if a lot of journeys are done throughout the day. The technology is worth its weight in gold.
     
  19. diamondnostril

    diamondnostril Type 1 · Well-Known Member

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    Hi all,

    Thanks to everybody for taking the time to look.

    I've now found what I was looking for . . . it's in the PDF which @GrantGam1337 was pointed to by the DVLA. In Chapter 03 on Diabetes Mellitus it's mentioned that all insulin-treated drivers must follow the information provided in 'Information for drivers with diabetes' which is given in the Appendix. In Appendix D on Page 114 you find this one-pager, labelled 'DIABINF'. It's implied that this printed page is sent to every insulin-treated driver.

    https://www.gov.uk/guidance/assessing-fitness-to-drive-a-guide-for-medical-professionals

    I've copy-and-pasted info from the DIABINF document below.

    Regards :)
    Antony



    DRIVERS WITH INSULIN TREATED DIABETES ARE ADVISED TO TAKE THE FOLLOWING PRECAUTIONS
    .

     You should always carry your glucose meter and blood glucose strips with you. You should check your blood
    glucose no more than 2 hours before the start of the first journey and every two hours whilst you are driving.

    If driving multiple short journeys, you do not necessarily need to test before each additional journey as long as
    you test every 2 hours while driving. More frequent testing may be required if for any reason there is a greater
    risk of hypoglycaemia for example after physical activity or altered meal routine. The intention is to ensure
    that blood glucose is always above 5.0mmol/l while driving.

     In each case if your blood glucose is 5.0mmol/l or less, take a snack. If lt is less than 4.0mmol/l or you feel hypoglycaemic, do not drive.

     If hypoglycaemia develops while driving, stop the vehicle as soon as possible.

     You should switch off the engine, remove the keys from the ignition and move from the driver’s seat.

     You should not start driving until 45 minutes after blood glucose has returned to normal (confirmed by
    measuing blood glucose). It takes up to 45 minutes for the brain to recover fully.

     Always keep an emergency supply of fast-acting carbohydrate such as glucose tablets or sweets within easy
    reach in the vehicle.

     You should carry personal identification to show that you have diabetes in case of injury in a road traffic
    accident.

     Particular care should be taken during changes of insulin regimens, changes of lifestyle, exercise, travel and
    pregnancy.

     You must take regular meals, snacks and rest periods on long journeys. Always avoid alcohol.
     
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  20. GrantGam

    GrantGam Type 1 · Well-Known Member

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    Nice one @diamondnostril; it's seems that yet again I've proved my inability to read things correctly:D
     
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