driving levels and my levels

[CaCl19]

When diagnosed 12 years ago I was quite forcibly told 5 don’t drive 4 hit the floor. On some threads people seem to delight in readings at this level. DVLA say to keep readings above 5 to drive and test every 2 hours.Do these people not drive?. When I get readings of around 7 DN wants to reduce meds.

I am now with new doctors surgery who actually listened when I told the about side effects on metformin and stopped it BS went up to around 15 gliclazide was introduced at 40/40 for 2 weeks BS down to 12’s, then to 40/80 and as long as it stays below 12 doctor intends to leave at that until hba1c at end of January. I am panicking about damage at these levels. Also I am on Emplagflozin.
What does community think please

 

[Rokaab]

If you are on insulin or other blood glucose lowering drugs (insulin, and stuff like gliclazide I think) you should not drive below 5 as you can go hypo quickly. - this is a DVLA rule.
If you are not on blood glucose lowering drugs you are fine as there should be nothing that will drop you sugar level quickly to be in a hypo, so type 2's just controlled by diet or metformin shouldn't go hypo, in fact non-diabetics can have BS levels of less than 5 (and probably often will) but they are very very unlikely to go hypo.
Note: I don't know what the rules for people with reactive hypoglycemia are

 

[jackois]

I think this is another case of why it's important to have a good understanding of how your own diabetes works. My type 1 is quite predictable, having nice steady rises and falls, rarely shooting up or down, which allows me to predict when I might need carbs or even insulin.

Whilst I wouldn't drive if I tested below 5, I know that a couple of jelly babies will have me above in a few minutes. On a journey, I'll stop and test after 2 hours as well, because that's what the rules are and should you be involved with the police for any reason while driving, they can ask to see your blood monitor readings.

Luckily, I also self fund the Dexcom continuous blood monitoring, and can have my BG reading on a smart watch face and monitor while driving.

I usually have a HB1AC around 5 and my GP would like it higher as he thinks to be this low you must be having hypos whilst sleeping. I've shown him that my trends stay steadily above 5 through the night, and although reassured by the CGM data, would still like to reduce medication to allow a rise to 7.

You don't mention what your diet and exercise regime is like, but some tweaks may help you to reduce your bloods further until you get back to your doctor in January. It maybe that he is fine tuning over a period and will adjusting to bring your sugars down steadily.

As ever, if it's a big worry, make another appointment and explain how you feel about having your blood sugars so high. I've never had any problem doing this with my GP and often they will appreciate that you are trying to help your self and not take your diabetes treatment for granted.

Hope this helps

 

[JoKalsbeek]

When diagnosed 12 years ago I was quite forcibly told 5 don’t drive 4 hit the floor. On some threads people seem to delight in readings at this level. DVLA say to keep readings above 5 to drive and test every 2 hours.Do these people not drive?. When I get readings of around 7 DN wants to reduce meds.

I am now with new doctors surgery who actually listened when I told the about side effects on metformin and stopped it BS went up to around 15 gliclazide was introduced at 40/40 for 2 weeks BS down to 12’s, then to 40/80 and as long as it stays below 12 doctor intends to leave at that until hba1c at end of January. I am panicking about damage at these levels. Also I am on Emplagflozin.
What does community think please

I'm thinking the "people who delight in readings at this level" are diet-only controlled, (I know I am) and don't have to worry about hypo's, because they don't usually happen in unmedicated T2's. Bit of a sweeping statement maybe, but that's most likely. But if you are on meds (or insulin) that can cause hypo's then yeah, 5 or higher is the rule, for safety and insurance reasons. (Far as I understand it, as a person without a licence.)

 

[kitedoc]

If you are on insulin or other blood glucose lowering drugs (insulin, and stuff like gliclazide I think) you should not drive below 5 as you can go hypo quickly. - this is a DVLA rule.
If you are not on blood glucose lowering drugs you are fine as there should be nothing that will drop you sugar level quickly to be in a hypo, so type 2's just controlled by diet or metformin shouldn't go hypo, in fact non-diabetics can have BS levels of less than 5 (and probably often will) but they are very very unlikely to go hypo.
Note: I don't know what the rules for people with reactive hypoglycemia are

Hi @Rokaab, I would be very very careful stating that people not on insulin or other BSL-lowering medications might be OK driving at low-normal BSL levels. Some people report getting hypo on metformin for example.
Should we not leave it to the professionally qualified to make pronouncements on BSLs and driving ??

 

[librarising]

If you are on insulin or other blood glucose lowering drugs (insulin, and stuff like gliclazide I think) you should not drive below 5 as you can go hypo quickly. - this is a DVLA rule.

This is NOT what my DVLA leaflet A Guide To Insulin Treated Diabetes says.
Rather
1. ... if your blood glucose is 5.0 mmol/L or less, TAKE A SNACK
2. ... if it is less than 4.0 mmol/L or you feel hypoglycaemic DO NOT DRIVE

I've yet to see an official statement, saying don't drive below 5.

Another 'myth' is that insulin users must test just before driving.
Rather
"you must check your blood glucose NOT MORE THAN 2 hours before the start of the first journey"

Do you have an official link to your 'rule' ?
Geoff
p.s. Capitals are mine.
Edited for p.s.

 

[KK123]

This is NOT what my DVLA leaflet A Guide To Insulin Treated Diabetes says.
Rather
1. ... if your blood glucose is 5.0 mmol/L or less, TAKE A SNACK
2. ... if it is less than 4.0 mmol/L or you feel hypoglycaemic DO NOT DRIVE

I've yet to see an official statement, saying don't drive below 5.

Another 'myth' is that insulin users must test just before driving.
Rather
"you must check your blood glucose NOT MORE THAN 2 hours before the start of the first journey"

Do you have an official link to your 'rule' ?
Geoff
p.s. Capitals are mine.
Edited for p.s.

Librarising, you are right. I'm guessing that most people prefer to be nearer the 5 than 4 though as it gives you a little leeway if you do start dropping. The second proviso, 'not more than 2 hours before the start of a journey' is strangely written I think because if you checked it at 3pm (and was fine) and then drove at 4.55pm without checking, it could be anything! Still, you would be within the law at least.

 

[Rokaab]

Hi @Rokaab, I would be very very careful stating that people not on insulin or other BSL-lowering medications might be OK driving at low-normal BSL levels. Some people report getting hypo on metformin for example.
Should we not leave it to the professionally qualified to make pronouncements on BSLs and driving ??

I'll try and write it better next time, I think I made it a bit too generic (I'm gonna blame the 1:40am waking up in a hypo moment so am now not entirely awake)

This is NOT what my DVLA leaflet A Guide To Insulin Treated Diabetes says.
I've yet to see an official statement, saying don't drive below 5.

Yeah I think I have seen that before, we'll call it a brain-fart cos I'm half asleep - though most docs will say 5 to drive, and I know I'm not sure I'd be happy to drive at the lower 4's

 

[kitedoc]

It is different in Australia. But as a diabetic for 52 years on insulin, not as professional opinion, I can see that it is sheer folly to assume that when taking insulin that a satisfactory BSL say 90 minutes before driving is any reassurance that one is not hypo at commencement of driving. It is absolutely NUTS.
The reason in Australia for 5 mmol/l limit at commencement of driving and every 1 to 2 hours with continued driving is that blood glucose meters are assumed to have an error rate of +/-15% (although recently some but not all glucose meters perform better than that error rate). So a reading of 4 mmol/l (which is the lower limit of the normal BSL range in some places) could be +/- 0.6 mmol/l = 3.4 to 4.6 mmol/l.
I would rather know that I commenced my driving trip as a diabetic on insulin with a current finger-prick BSL at 5 mmol/l or higher.
And even if the DVLA has such daft rules, what is to stop a lawyer showing that with a 15% error rate in the finger prick BSL reading that the diabetic-on-insulin driver could have been hypoglycaemic before their motor car accident.??

 

[librarising]

It is different in Australia.
And even if the DVLA has such daft rules, what is to stop a lawyer showing that with a 15% error rate in the finger prick BSL reading that the diabetic-on-insulin driver could have been hypoglycaemic before their motor car accident.??

UK justice doesn't work like that.
In my first reply, I was arguing law, NOT good practice. It may, for some, make good sense for BS to be 6 or above before driving.
Does it make sense for a 7am blood test to allow me to jump in a car at 8.55 for a 5-mins drive ? That's another matter.
Geoff

 

[DCUKMod]

When diagnosed 12 years ago I was quite forcibly told 5 don’t drive 4 hit the floor. On some threads people seem to delight in readings at this level. DVLA say to keep readings above 5 to drive and test every 2 hours.Do these people not drive?. When I get readings of around 7 DN wants to reduce meds.

I am now with new doctors surgery who actually listened when I told the about side effects on metformin and stopped it BS went up to around 15 gliclazide was introduced at 40/40 for 2 weeks BS down to 12’s, then to 40/80 and as long as it stays below 12 doctor intends to leave at that until hba1c at end of January. I am panicking about damage at these levels. Also I am on Emplagflozin.
What does community think please

@CaCl19 - What sort of medication, if any, do you take to help manage your diabetes?

Most T2s, not on insulin, or the more aggressive drugs, like Gliclazide (as opposed to Metformin) are not supported in testing, so most have zero clue what their bloods are at any given moment, never mind when they might be considering getting behind the wheel.

For myself, I was diagnosed just over 5 years ago with an A1c of 73, but negotiated a few months to "see what I could do with diet" - so no meds, and certainly no supported testing. Without any enquiry about my background or training, I was told I wouldn't understand the results (nice!).

Nonetheless, I self-funded my testing, as interpreting a reading isn't rocket science, once we have the b asics under our belt. Very quickly, after reducing or eliminating my blood sugar rocket fuel, my blood glucose scores medrated, and my next test came in at 37 and has never been that high again. My last was 30 - still unmedicated.

When I test, unless it is very soon after a big meal, including some carbs, I very, very raely see a 5, so theoretically I should be snacking like mad. I'm not.

I now see that my body has undergone a period of recovery from the glucose assault that was going on around my diagnosis, and now works more "normally".

If it were important that those diabetics not taking medication, or on the mighter weight stuff, like Metformin, I feel certain the medics would either support it, or issue appropriate warnings about either testing or desisting from driving.

Obviously, not matter what anyone's blood sugar levels are, they should not drive if they feel unwell, or consider they might be having a hypo. In that circumstance they should either test and act accordingly, or if they are unable to test, they would be best placed to have a small something to eat or drink to see if they feel a bit better after 15 minutes or so.

Let's face it. The general population don't test, and therefore for the most part will have zero idea what their blood sugars are at any given time.

Sometimes the written word is confusing, but that is my take on it, and having challenged an Endo making a presentation about the DVLA Guidelines, he agreed with my take on it.

I do think that on here, we are a bit at odds with many diabetics, in that we tend to be very motivated to be the best we can on a day-to-day, month-by-month basis. I'm not saying anyone who doesn't come here is totally oblivious or devile may care; maybe thay they're just not quite so tuned into the detail as we might have become.

On a final and more general note, you profile doesn't tell us much about you, which can make it trickier for folks to give your tailored responses. Would you consider maybe updating your profile to include the diabetes medication you take. You don't have to, but it helps a lot.

 

[CaCl19]

I think this is another case of why it's important to have a good understanding of how your own diabetes works. My type 1 is quite predictable, having nice steady rises and falls, rarely shooting up or down, which allows me to predict when I might need carbs or even insulin.

Whilst I wouldn't drive if I tested below 5, I know that a couple of jelly babies will have me above in a few minutes. On a journey, I'll stop and test after 2 hours as well, because that's what the rules are and should you be involved with the police for any reason while driving, they can ask to see your blood monitor readings.

Luckily, I also self fund the Dexcom continuous blood monitoring, and can have my BG reading on a smart watch face and monitor while driving.

I usually have a HB1AC around 5 and my GP would like it higher as he thinks to be this low you must be having hypos whilst sleeping. I've shown him that my trends stay steadily above 5 through the night, and although reassured by the CGM data, would still like to reduce medication to allow a rise to 7.

You don't mention what your diet and exercise regime is like, but some tweaks may help you to reduce your bloods further until you get back to your doctor in January. It maybe that he is fine tuning over a period and will adjusting to bring your sugars down steadily.

As ever, if it's a big worry, make another appointment and explain how you feel about having your blood sugars so high. I've never had any problem doing this with my GP and often they will appreciate that you are trying to help your self and not take your diabetes treatment for granted.

Hope this helps

Diet is well controlled. Excercise is park run (I mainly walk, as both knees reconstructed) on Saturday aqua aerobics twice a week plus movement and flexibility classes. I lost 3stone due to stress of losing husband and started having hypos so gliclazide at 160/160 was reduced then stopped. Because of problems with metformin which were ignored (said diverticulitis) when changed doctors they listened and stopped the metformin which now means trying to get balance right again. So frustrating

 

[CaCl19]

@CaCl19 - What sort of medication, if any, do you take to help manage your diabetes?

Most T2s, not on insulin, or the more aggressive drugs, like Gliclazide (as opposed to Metformin) are not supported in testing, so most have zero clue what their bloods are at any given moment, never mind when they might be considering getting behind the wheel.

For myself, I was diagnosed just over 5 years ago with an A1c of 73, but negotiated a few months to "see what I could do with diet" - so no meds, and certainly no supported testing. Without any enquiry about my background or training, I was told I wouldn't understand the results (nice!).

Nonetheless, I self-funded my testing, as interpreting a reading isn't rocket science, once we have the b asics under our belt. Very quickly, after reducing or eliminating my blood sugar rocket fuel, my blood glucose scores medrated, and my next test came in at 37 and has never been that high again. My last was 30 - still unmedicated.

When I test, unless it is very soon after a big meal, including some carbs, I very, very raely see a 5, so theoretically I should be snacking like mad. I'm not.

I now see that my body has undergone a period of recovery from the glucose assault that was going on around my diagnosis, and now works more "normally".

If it were important that those diabetics not taking medication, or on the mighter weight stuff, like Metformin, I feel certain the medics would either support it, or issue appropriate warnings about either testing or desisting from driving.

Obviously, not matter what anyone's blood sugar levels are, they should not drive if they feel unwell, or consider they might be having a hypo. In that circumstance they should either test and act accordingly, or if they are unable to test, they would be best placed to have a small something to eat or drink to see if they feel a bit better after 15 minutes or so.

Let's face it. The general population don't test, and therefore for the most part will have zero idea what their blood sugars are at any given time.

Sometimes the written word is confusing, but that is my take on it, and having challenged an Endo making a presentation about the DVLA Guidelines, he agreed with my take on it.

I do think that on here, we are a bit at odds with many diabetics, in that we tend to be very motivated to be the best we can on a day-to-day, month-by-month basis. I'm not saying anyone who doesn't come here is totally oblivious or devile may care; maybe thay they're just not quite so tuned into the detail as we might have become.

On a final and more general note, you profile doesn't tell us much about you, which can make it trickier for folks to give your tailored responses. Would you consider maybe updating your profile to include the diabetes medication you take. You don't have to, but it helps a lot.

Have updated profile

 

[DCUKMod]

Have updated profile

Fab! Thanks.