Testing with the Libre - Changes in the rules for driving

[KenBachelor]

I'm sure this information must have been posted somewhere but I can't find it, so please accept my apologies for any duplication. We were asked a couple of weeks ago to write to our MP's about the delay in approving the Libre test for driving and I've now received the following from my MP.

Assuming that what he says is correct, it looks as if we can stop testing with blood by the end of the month!

Dear Ken

Thank you for contacting me about the Driving Vehicle Licensing Agency (DVLA) guidance on the use of monitoring technologies for people living with diabetes.

I appreciate your concerns, and understand that the DVLA is currently in the process of amending the Assessing Fitness to Drive guidance on the use of new monitoring technologies for people who suffer from diabetes.

My Ministerial colleagues have reassured me that the updated guidance is intended for publication in February. It is welcome news that the guidance will allow for the testing of interstitial fluid for driving licensing purposes for car or motorcycle drivers who have diabetes. Goods vehicle and bus drivers must continue to monitor their blood glucose levels.

I hope this response has provided a measure of clarity and reassurance, and I will continue to monitor the updated guidelines closely.

Thank you again for taking the time to contact me.

Warm regards

Nadhim

Nadhim Zahawi
MP for Stratford on Avon

 

[Copernicus]

Well done, about time the DVLA saw sense in this matter. Now all we need is for all of us to get it free on the NHS

 

[porl69]

I really do not know where I stand on the Libre and driving! I am one of the lucky ones whos Libre readings are very accurate. There are a lot of posts on here and social media about the vast differences in readings. So you could have a Libre reading of 5 (safe to drive) and actually be hypo! A fair few diabetics are hypo unaware. Still think finger pricking should be used before driving

 

[Deleted Account]

I know this mentions the use of "interstitial fluid" but it effectively means CGM which provides more information than finger pricks.
I have always thought a reading of at least 5mmol/l every 2 hours is a pragmatic solution to a complex problem.
If my reading is 4.7 and stable (or rising), I may be safer to drive than someone with a BG of 5.2 and falling.
CGM provides this trend in formation so, would be useful to use that for driving.

 

[Copernicus]

I really do not know where I stand on the Libre and driving! I am one of the lucky ones whos Libre readings are very accurate. There are a lot of posts on here and social media about the vast differences in readings. So you could have a Libre reading of 5 (safe to drive) and actually be hypo! A fair few diabetics are hypo unaware. Still think finger pricking should be used before driving

Yes, but you could fingerprick and get a reading say of 5 but you could actually be dropping. At least the Libre shows if you are rising or falling.

 

[sninge]

Sometimes my libre doesn't give me accurate readings but the ones I've had have always read lower when I was low and higher when I was high!! Don't think I have in the last 1.5 yrs had one that said I wasnt below 4 when my meter said I was!! I do understand though that it is better to be safe than sorry esp when we could kill someone by driving hypo!!

 

[KenBachelor]

Used sensibly, the Libre does everything we need. When I take a reading it tells me whether the trend is dropping or rising. We all know that the readings give the position about 10 minutes ago and as I never drive unless my reading is 7mmol or higher I can use that knowing whether it's going the wrong way.

We've always been told that we mustn't drive unless the B/G is more than 5mmol and that having set off, we must test again every 2 hours! Anyone following those rules is asking for trouble and risking the life of other road users.

 

[Deleted Account]

We've always been told that we mustn't drive unless the B/G is more than 5mmol and that having set off, we must test again every 2 hours! Anyone following those rules is asking for trouble and risking the life of other road users.

I disagree.
If my BG is stable (which I can tell with Libre) and I have no bolus insulin on board, I am risking no one’s life by driving at 5.0.
In fact, if my BG is too high (for me, this is above 8mmol/l), I struggle to concentrate and feel sleeping which I think is more risky.
I am pretty sure, before, I had diabetes, I would drive with my BG is the 4s.

The point is, we are all different and have a duty to ourselves and others to take care when driving. For some this may be ensuring our BG is alive 7 and for others it may be ensuring our BG is stable and between 5 and 7.

Edited to add: I (and I think others) find driving causes my BG to rise. So driving for 2 hours starting at 5mmol/l with no bolus on board is likely to result in a reading of around 6 or 7. Further reasons for not needing such a high starting BG to be safe to drive.

 

[Stephen Lewis]

Sometimes my libre doesn't give me accurate readings but the ones I've had have always read lower when I was low and higher when I was high!! Don't think I have in the last 1.5 yrs had one that said I wasnt below 4 when my meter said I was!! I do understand though that it is better to be safe than sorry esp when we could kill someone by driving hypo!!

I used Libre and finger pricking for my first 2 weeks using CGM. The finger pricking always measured between 1.0 and 1.5 above the Libre even allowing for a time delay. I also generally feel hypo when my finger pricking is about 5.5, but not when the Libre is between 4.5 and 5. You can easily take a reading on the Libre while driving not so easy to continuously check with blood on a long car trip.

 

[evilclive]

We've always been told that we mustn't drive unless the B/G is more than 5mmol and that having set off, we must test again every 2 hours! Anyone following those rules is asking for trouble and risking the life of other road users.

Is there a "not" missing before the word "following"?

FWIW the rules around driving cars don't say anything about 5.0, that's just advice to keep you away from 4.0, where authorities would start to complain. They do say test every 2 hours though, though that is a fairly recent addition to the rules - for a long time it was just "Must not be hypo".

I'm looking forward to this. IMO the libre gives a much better idea of whether it's safe or not to drive, especially because it's trivial to read while driving (I get a passenger to wave it at my arm) so you get a much faster idea of problems coming up - I'm a lot more likely to do a quick confirmatory test if it's that easy than if it effectively adds 10 minutes to a journey (wait for suitable stopping point, stop, measure, start again)

 

[Listlad]

Used sensibly, the Libre does everything we need. When I take a reading it tells me whether the trend is dropping or rising. We all know that the readings give the position about 10 minutes ago and as I never drive unless my reading is 7mmol or higher I can use that knowing whether it's going the wrong way.

We've always been told that we mustn't drive unless the B/G is more than 5mmol and that having set off, we must test again every 2 hours! Anyone following those rules is asking for trouble and risking the life of other road users.

@KenBachelor Do police officers have the capacity to check?

 

[Deleted Account]

@KenBachelor Do police officers have the capacity to check?

I assume they can ask us to prove we were safe to drive and we can do this by showing the history on our test meter.
If we fail to do so following an accident, I assume I am handing my insurers a reason not to cover me.

 

[Listlad]

I assume they can ask us to prove we were safe to drive and we can do this by showing the history on our test meter.
If we fail to do so following an accident, I assume I am handing my insurers a reason not to cover me.

Same if you don’t have a Libre?

 

[Deleted Account]

Same if you don’t have a Libre?

Yes. Al test meters I have used for the last 15 years have a history.

 

[Glucobabu]

@KenBachelor Do police officers have the capacity to check?

I was recently told by my DSN that they would actually ask to see your meter to confirm your last test. I was and still am a little dubious about that!

 

[Glucobabu]

Same if you don’t have a Libre?

Why would it be different?

 

[jackois]

I think the showing your meter to the police would be a matter of how switched on the officer is. I would think that a traffic officer would be more clued up on the legislation. There's nothing on the licence indicating that I have diabetes.

However, the rules say test before driving and then every 2 hours during your journey and it's a matter of a minute to do so.

That said, I agree with the others that I have enough experience of my diabetes to know whether my blood sugars are rising, falling or stable. I have the Dexcom G5 and am due to change to the G6 after this sensor. For driving it's excellent because it will give a trend bluetoothed to my smartwatch and I can see the general trend and act accordingly.

 

[Listlad]

Just looked on the Freestyle Libre website. Apart from them saying there is a shortage now and that only existing customers will be catered for immediately, they also mentioned the DVLA thing...

“The DVLA does not consider interstitial fluid glucose readings, such as those provided by the FreeStyle Libre sensors, to be sufficient on their own and drivers must also monitor their blood glucose levels using a traditional blood glucose test.”

I was going to order one.

 

[evilclive]

Just looked on the Freestyle Libre website. Apart from them saying there is a shortage now and that only existing customers will be catered for immediately, they also mentioned the DVLA thing...

“The DVLA does not consider interstitial fluid glucose readings, such as those provided by the FreeStyle Libre sensors, to be sufficient on their own and drivers must also monitor their blood glucose levels using a traditional blood glucose test.”

I was going to order one.

Are you on insulin and with a medically restricted licence? If not, then the DVLA rules don't apply to you.

 

[Listlad]

Are you on insulin and with a medically restricted licence? If not, then the DVLA rules don't apply to you.

No and no, Clive. Simply learning as I go. I might end up Type 2 eventually so am thinking ahead.

I do not know anything about medically restricted licenses so am wondering who they might apply to and how it might affect me.

Googling, I see retinopathy and neuropathy is a reason given for restriction, so that could apply to me eventually.

I am also very interested in the Libre device.

Does that answer your question @evilclive ?