In England, I have to have a 3 year medical assessment and renewal, but there is no charge. You may well be healthy, but if you take insulin, you are susceptible to hypos. Whether we like it or not, diabetes related scenarios (hypos being the first to spring to mind) put us at risk of losing control of the vehicle, and for that reason, I feel safer that I, but more importantly every other T1 diabetic, is assessed. Sadly, the New years crash where the bin lorry driver in Scotland had not declared his (non diabetes related) medical conditions meant he slipped through the net. I think it is only fair that we accept the DVLA must do all it can to prevent this wherever possible.
As I understand it, alcoholics - who are potentially at a greater risk of drink driving - don't have to have a restricted license with their medical support signing off that their addiction is under control regularly. Neither do many people with conditions that could affect their ability to drive.
But diabetics do have to.
And the law is clear: if you are not fit to drive, it is against the law to get behind the wheel. Irrespective of whether you have a medical condition or not, if - at that point - you are not well rested, not got good blood sugar levels, over the alcohol limit, been taking any medication that cause drowsiness, etc - then you must not get behind the wheel of a vehicle.
Out of everything I had when I was diagnosed, surrendering my driving license was the biggest thing for me. I don't drive when I am unwell or had a drink or am sure I am fit to drive. Being diabetic didn't change that; it's an implicit and explicit responsibility that comes with my license. But suddenly I was no longer trusted that I was able to make that decision without a doctor and the DVLA deciding I could keep track of my blood sugars.
I follow the guidance: test no more than 30 minutes before getting in the car, check every two hours. Don't drive if hypo and within 45 minutes of being hypo. Take carbs if under 5 mmol/l. Why would anyone not follow that to stay safe on the road?
But the DVLA still consider night-time hypoglycemic episodes which they don't with other conditions.
I felt the rules were unnecessarily harsh to penalise diabetics. After all, if I drive and I have an accident and it was found that I knowingly got behind the wheel of a car without being fit to drive, I would rightly be prosecuted. Diabetes or no diabetes.