The Beginning of the End.....

[Sable_Jan]

I started off diet controlled for about 7 years then was shocked to be given Metformin and insulin 3 years ago. I started off on 0.5 units of Novarapid per 10g carbs after evening meal but this had gradually risen and now it's up to 2 units per 10g. I'm really upset about it as I feel like a failure if BG is on the high side 2 hours after injection. I find it really hard not to eat during this 2 hours especially if my partner is stuffing his face with chocolate :-(


Sent from the Diabetes Forum App

I found out how much I snack within 2 hours of a meal - at least testing after meals makes me aware and snack less (even though I make better choices these days)

 

[Alanp35]

HimJan
1.5=LADA= late onset type 1.
Some of us are running late . . . . . Lol




Sent from the Diabetes Forum App

 

[ShellyC23]

Sorry but I think your looking at it the wrong way. Its not about dragging anyone down it's about being fair to all. It should be one rule for everyone, not discriminating rules against insulin users! The risk is hypos, not insulin usage, so either the DVLA stop discriminating against insulin users and allow them to have the same license as sulfonylurea users have or they make BOTH diabetic groups abide by the same licensing rules!! That's my opinion, I think it's fair and I'm sticking to it.


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.

Sent from the Diabetes Forum App

 

[ShellyC23]

Elaine, I'd love to join in on this discussion but as a non-driver I don't really qualify, however I have to agree with every point you make on this one!


Sent from the Diabetes Forum App

 

[mo1905]

I agree with Elaine, anyone at risk of going hypo, whatever the meds, should abide by the same rules. If anything, those on insulin have more control. Just one thing on the testing/driving though, you can drive below 5, you just need a snack as well. You cannot drive below 4.0, you have to wait at least 45mins after getting back to 5.


Sent from the Diabetes Forum App

 

[mo1905]

-The applicant or licence holder must notify DVLA unless stated otherwise in the textRevised March 2013A Guide to Insulin Treated Diabetes and DrivingDrivers who have any form of diabetes treated with any insulin preparation must inform DVLA (Caveat: See Temporary Insulin Treatment)HYPOGLYCAEMIAHypoglycaemia (also known as a hypo) is the medical term for a low blood glucose (sugar) level.Severe hypoglycaemia means the assistance of another person is required.The risk of hypoglycaemia is the main danger to safe driving and this risk increases the longer you are on insulin treatment. This may endanger your own life as well as that of other road users. Many of the accidents caused by hypoglycaemia are because drivers carry on driving even though they get warning symptoms of hypoglycaemia . If you get warning symptoms of hypoglycaemia whilst driving, you must always stop as soon as safely possible – do not ignore the warning symptoms.EARLY SYMPTOMS OF HYPOGLYCAEMIA INCLUDE:Sweating, shakiness or trembling, feeling hungry, fast pulse or palpitations, anxiety, tingling lips. If you don’t treat this it may result in more severe symptoms such as:Slurred speech, difficulty concentrating, confusion, disorderly or irrational behaviour, which may be mistaken for drunkenness.If left untreated this may lead to unconsciousness.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 30 minutes 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. 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. It takes up to 45minutes for the brain to recover fully. Always keep an emergency supply of fast-acting carbohydrate such as glucose tablets or sweets within easyreach in the vehicle. You should carry personal identification to show that you have diabetes in case of injury in a road trafficaccident. Particular care should be taken during changes of insulin regimens, changes of lifestyle, exercise, travel andpregnancy. You must take regular meals, snacks and rest periods on long journeys. Always avoid alcohol.EYESIGHTAll drivers are required by law to read, in good daylight (with glasses or corrective lenses if necessary), a car number plate from a distance of 20 metres. In addition, the visual acuity (with the aid of glasses or contact lenses if worn) must be at least 6/12 (0.5 decimal) with both eyes open, or in the only eye if monocular.LIMB PROBLEMSLimb problems/amputations are unlikely to prevent driving. They may be overcome by driving certain types of vehicles e.g. automatics or one with hand controls.YOU MUST INFORM DVLA IF: You suffer more than one episode of severe hypoglycaemia (needing the assistance of another person) within the last 12 months. For Group 2 drivers (bus/lorry) one episode of severe hypoglycaemia must be reported immediately. You must also tell us if you or your medical team feels you are at high risk of developing hypoglycaemia. You develop impaired awareness of hypoglycaemia. (difficulty in recognising the warning symptoms of low blood sugar) You suffer severe hypoglycaemia while driving. An existing medical condition gets worse or you develop any other condition that may affect you driving safely.CONTACT USWeb site: www.gov.uk/browse/drivingTel: 0300 790 6806 (8.00am. to 5.30pm. Mon – Fri) & (8.00 am. to 1pm. Saturday)Write: Drivers’ Medical Group, DVLA, Swansea SA99 1TUFor further informations on diabetes visit www.diabetes.org.uk Rev: Jan 13DIABINF


Sent from the Diabetes Forum App

 

[spurslad]

I'm type 2 insulin dependant and have been told I have to inform the DVLA so today will be the day of judgement and let them know. I can see where everyone is coming from and as I was on gliclazide and had hypos on it while I was a lorry driver I think that people on this medication should also be subject to the same rules as insulin dependant people.



Sent from the Diabetes Forum App

 

[elaine77]

Surely the longer ur on insulin the LESS likely you are to hypo as you will have hypo awareness and much more control and experience??


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.

 

[equipoise]

Hypos caused by insulin injection do of course have the potential to be much more severe than those caused by taking sulfonylureas. But why not try running a straw poll on a new thread, asking people to state how frequent and severe their hypos are, and whether they are on insulin or sulfonylureas? It won't prove anything statistically, but it might be an interesting exercise.

 

[elaine77]

It's not about how many hypos people have because the DVLA aren't bothered about how many they are just bothered about the RISK of it happening and there is a risk with sulfonylureas as well as insulin and so the rules should be the same for both. Like someone already said, they had been a paramedic for ages and never once came across an accident that was caused due to hypo. If the DVLA were basing the rules on frequency of accidents caused by hypo the chances are there wouldn't even be any at all. Someone just said higher up as well that they had hypos all the time on sulfonylureas!

Everyone who believes in this fairness should write to the DVLA about it, maybe if they get enough pressure they will reform their rules and make the 3 year licence applicable to everyone who could potentially go hypoglycaemic.


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.

 

[smidge]

No Smidge I was hoping you didn't mean that it was safe to drive with bg numbers in the 3's as that would be rather foolish, it wasn't quite clear to me what you were trying to say as you were saying non-diabetics spend time in the 3's but you thought you were being discriminated against because the DVLA are wanting you to aim for higher levels........

But my point is that if DVLA are defining hypo as 4 and we are not allowed to drive with our BG under this level and we have to eat something if our BG is at 5 or below at the outset of driving - and then wait 45 minutes before we drive - why are non-diabetics allowed to drive with their BG in the 3s? Like Elaine, I just want fairness. If 4 is hypo in DVLA rules why is it OK for a non-diabetic to drive with their BGs below that level??? For a big proportion of time, a big proportion of the non-diabetic population are driving while having a hypo (at least as defined by DVLA rules)!

Smidge

 

[mo1905]

You're probably better of writing to your MP's. DVLA have a "don't give a **** attitude". They just follow guidelines. Also, the DVLA do care about the number of hypo's as they ask in their paperwork. They also take notice from your consultant and if he/she says you continually hypo, no matter severity, it won't look good. The longer you're on insulin does not always mean better control or less hypo's, often the reverse as years ago, less was known and people don't like/accept change. I've found the more recently diagnosed generally seem to know more about their condition, barring those on this forum of course. Perhaps it would be interesting if DUK or similar would press the Police/DVLA/Gov't for numbers off accidents caused which are diabetes related as opposed to other medical conditions.

 

[mo1905]

But my point is that if DVLA are defining hypo as 4 and we are not allowed to drive with our BG under this level and we have to eat something if our BG is at 5 or below at the outset of driving - and then wait 45 minutes before we drive - why are non-diabetics allowed to drive with their BG in the 3s? Like Elaine, I just want fairness. If 4 is hypo in DVLA rules why is it OK for a non-diabetic to drive with their BGs below that level??? For a big proportion of time, a big proportion of the non-diabetic population are driving while having a hypo!

Smidge

How do we know firstly that non-diabetics regularly drive in the 3's ? Unless they're testing. Also, even if they were, they're not on meds which will cause them to drop further. The DVLA has allowed a safety zone in their figures of below 4. Most diabetics feel perfectly fine at 4 and would be safe to drive. The guidelines are there to ensure we don't continue to drop to 1's and 2's.

 

[equipoise]

It's not about how many hypos people have because the DVLA aren't bothered about how many they are just bothered about the RISK of it happening and there is a risk with sulfonylureas as well as insulin and so the rules should be the same for both. Like someone already said, they had been a paramedic for ages and never once came across an accident that was caused due to hypo. If the DVLA were basing the rules on frequency of accidents caused by hypo the chances are there wouldn't even be any at all. Someone just said higher up as well that they had hypos all the time on sulfonylureas!

Everyone who believes in this fairness should write to the DVLA about it, maybe if they get enough pressure they will reform their rules and make the 3 year licence applicable to everyone who could potentially go hypoglycaemic.


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.

No Elaine -- I was responding to your post where you claimed that people on insulin were LESS likely to have hypos, and I was merely suggesting that it might be useful to get a straw poll on that. It is clear from your latest post that you are not remotely interested in challenging why insulin-using diabetics should have a 3-year license (as smidge is). You are only interested in demanding that more diabetics should have to suffer if you are. I will certainly not be writing to my MP demanding that I and others on sulfonylureas must be put on 3-year licenses, just so that you can feel gratified. If your GP actually decides to put you on sulfonylureas rather than insulin, will you be demanding to be put on a 3-year license because otherwise it isn't fair? Be honest.

 

[mo1905]

I don't think Elaine, or myself, are demanding those on sulfonylureas should get their license restricted. Rather, insulin dependant diabetics are afforded the same guidelines. Any diabetic, if control is good, should not be restricted.

 

[smidge]

How do we know firstly that non-diabetics regularly drive in the 3's ? Unless they're testing. Also, even if they were, they're not on meds which will cause them to drop further. The DVLA has allowed a safety zone in their figures of below 4. Most diabetics feel perfectly fine at 4 and would be safe to drive. The guidelines are there to ensure we don't continue to drop to 1's and 2's.

Well, we know that non-diabetic HbA1cs are often in the 4s - to get them there they must spend a good proportion of their time in the 3s - so they must drive like that. We also know that non-diabetic levels can actually fall into the 2s - that was demonstrated quite clearly in the Fat v Sugar programme the other week. The doctor who was measured at 2.9 would have been perfectly legal to drive like that. Is that a hypo or not? Could he think clearly at that level or not? If he was diabetic on insulin, the same action would be illegal. Is that discrimination?

My BG doesn't fall suddenly because I don't take enough insulin at breakfast or lunch to make that happen and I don't eat enough carb to get the mad BG swings. I also understand perfectly when the risk times are for my BG to go slightly low - although never as low as the doctor mentioned above. So am I just being punished for the poor control of other diabetics? As far as I'm concerned, that is discrimination on the basis of my disability as it does not take my personal circumstances into account.

Smidge

 

[smidge]

I don't think Elaine, or myself, are demanding those on sulfonylureas should get their license restricted. Rather, insulin dependant diabetics are afforded the same guidelines. Any diabetic, if control is good, should not be restricted.

Yes, that's exactly my point Mo. The rules should be fair, consistent and apply to all.

Smidge

 

[mo1905]

Well, we know that non-diabetic HbA1cs are often in the 4s - to get them there they must spend a good proportion of their time in the 3s - so they must drive like that. We also know that non-diabetic levels can actually fall into the 2s - that was demonstrated quite clearly in the Fat v Sugar programme the other week. The doctor who was measured at 2.9 would have been perfectly legal to drive like that. Is that a hypo or not? Could he think clearly at that level or not? If he was diabetic on insulin, the same action would be illegal. Is that discrimination?

My BG doesn't fall suddenly because I don't take enough insulin at breakfast or lunch to make that happen and I don't eat enough carb to get the mad BG swings. I also understand perfectly when the risk times are for my BG to go slightly low - although never as low as the doctor mentioned above. So am I just being punished for the poor control of other diabetics? As far as I'm concerned, that is discrimination on the basis of my disability as it does not take my personal circumstances into account.

Smidge

Hey, I'm not saying I like the rules. It took me 12 months to get my LGV license back. I'm just saying why the rules are there and why non-diabetics can drive. There will always be the extreme occasion when someone drives who shouldn't but they can't govern for every single circumstance. Extreme tiredness, hay fever tablets etc, all interfere with people's ability to concentrate but how can you police that ? Laws are there for the majority, not just for yourself, myself to TV presenters. I think the Gov't and DVLA do discriminate, but for different reasons.

 

[noblehead]

But my point is that if DVLA are defining hypo as 4 and we are not allowed to drive with our BG under this level and we have to eat something if our BG is at 5 or below at the outset of driving - and then wait 45 minutes before we drive - why are non-diabetics allowed to drive with their BG in the 3s? Like Elaine, I just want fairness. If 4 is hypo in DVLA rules why is it OK for a non-diabetic to drive with their BGs below that level??? For a big proportion of time, a big proportion of the non-diabetic population are driving while having a hypo (at least as defined by DVLA rules)!Smidge

But your forgetting that non-diabetics regulate insulin and glucose levels naturally where we have to administer insulin by injection, administering insulin by injection or pump is less predictable and for whatever reason our bodies are less effective in dealing with falling bg levels....hence why when we go hypo we have to treat with fast-acting glucose to get us out of trouble.

There has to be a margin of error with bg and that is why they state that the safe level in which insulin dependant diabetics can drive is 5mmol, were it to be 4mmol and someone's insulin is still active then in no time at all that bg could soon in up in the 2's, which undeniably is a pretty dangerous place to be.

At the end of the day these are safeguards for all diabetics and the DVLA will not make allowances by going on one persons experiences, as I say Smidge it's all about keeping road users and pedestrians safe.

 

[mo1905]

But your forgetting that non-diabetics regulate insulin and glucose levels naturally where we have to administer insulin by injection, administering insulin by injection or pump is less predictable and for whatever reason our bodies are less effective in dealing with falling bg levels....hence why when we go hypo we have to treat with fast-acting glucose to get us out of trouble.

There has to be a margin of error with bg and that is why they state that the safe level in which insulin dependant diabetics can drive is 5mmol, were it to be 4mmol and someone's insulin is still active then in no time at all that bg could soon in up in the 2's, which undeniably is a pretty dangerous place to be.

At the end of the day these are safeguards for all diabetics and the DVLA will not make allowances by going on one persons experiences, as I say Smidge it's all about keeping road users and pedestrians safe.

So Noblehead, do you think those on Gliclazide, for example, should not be required to follow same DVLA guidelines as insulin dependant ?