Another Test Strip Thread

Hi Sid.

INSULIN TREATED and a Driver ?
Drivers are sent a detailed letter of explanation about their licence and driving by DVLA.
If the person has incidents of disabling Hypoglycaemia this will affect the licence. You also have to be aware of Hypo symptoms. So if you lose your awareness you could lose your licence ?

Here is a link to the current September 2009 guidelines from the DVLA.http://www.dft.gov.uk/dvla/medical/ataglance.aspx

NICE guidelines are also specific about what should happen in relation to Insulin and Driving. This also encompasses other Hypo inducing medications such as Byetta and Victoza.

An extract. This is from T2 guidance but T1 is the same.
Self-monitoring of plasma glucose should
be available:
● to those on insulin treatment
● to those on oral glucose-lowering
medications to provide information
on hypoglycaemia
● to assess changes in glucose control resulting
from medications and lifestyle change
● to monitor changes during intercurrent illness
● to ensure safety during activities,
including driving.

So your Nurse is on the ball and up to date. Makes a change ? Not sure about the 6 mmol/l, I think that is just her interpretation. Providing you are aware of what is happening I can see no reason why the level couldn't be a bit lower. Never below 4 mmol/l though....that is a Hypo.

Recently I had a minor problem with a new GP not giving me enough test strips. After a discussion with said GP in which I pointed out that I travel on the Motorways several times weekly and had suffered a few Hypo's recently I asked if he was going to be responsible if I had an accident, because I was unable to test my Bg levels prior to and during driving distances ? The upshot was that he prescribed twice as many as I asked for and I no longer have the problem. Surprising what a little chat will do.

Sid
Your nurse would stop me driving. I don't use insulin, but I also don't allow my bg to go over 6.
Hana

Sid, I wrote to DVLA earlier this year, questioning the apparent disparity between the requirement to test before driving and the limiting of test strip prescribing. Eventual response: "DVLA do not make clinical recommendations". From which I can only infer if you are having difficulty obtaining enough test strips from your GP, highlight the DVLA position.

Your nurse is spot on, I'm staggered how rare this advice is. I don't drive anyway, but remember from my DAFNE course the tag-line "don't drive below five".

In my hospital work, I often come across the phrase "safety bloods". This means blood tests done regularly to ensure medication is not harming the liver etc. I've never heard of a GP refusing to perform (and thus, fund) "safety bloods" unless the drug involved can only be prescribed by a hospital specialist - which obviously doesn't apply to insulin, metformin etc. For diabetics on hypo-inducing treatment, bs tests before driving could be described as "safety bloods". The only difference is that we do the tests and act on the results ourselves.

Might be a useful phrase to use when asking for test strips.

I always carry a meter and box of strips in my car, this is a totally different meter to my main meter, so I need to order different stick for this, told my doctor that the meter and sticks were for saftey reasons ie. driving. He agreed it was a good idea and no problem getting the sticks.

But I am type 1 so maybe easier for me to do that.

I am surprised about 6.0. I am T2, diet and exercise only - and I don't low carb - and my bg is often under 6.

Does this mean I should only drive within an hour of eating a meal?

Well I drive all the time with bg under 6, and have no intention of stopping while controlled on diet only! I am presuming I wouldn't go hypo, just get famished - for which I used to access a kitkat and now, sadly, have to have a piece of cheese. How times are changed!
DG

On Saturday and Sunday I drive to Portobello road Market in London from Bedford , it's quite strenuous unloading the stock from the car and taking it to the stall ( ie a lot of excersize ) , I eat at 6 arrive at 7 unload and test my BG at 8 , 2 hours after eating , it is in the range 3.6 to 5. 2 . I have never felt "ill" even when it was 3.6 and haven't eaten "lunch" until 12 , and have sometimes driven my car before lunch to pick up some more stock , I have never been advised of the DLVA levels , no one mentioned this at the diabetes clinic , should I be worried ? can I hypo as a type 2 or does my lack of illness suggest there won't be a problem ?

If you are a type 2 on any of the hypo inducing medications, ie insulin, Byetta, Gliclizide etc then you can hypo. If you are on metformin you may go low but will not go so low as to pass out as your liver will ' dump' and bring your blood sugar levels back up. You only have to notify DVLA if you are on Insulin. Check with the website for the latest information.

http://www.direct.gov.uk/en/Motoring/DriverLicensing/MedicalRulesForDrivers/DG_10030957

The above link is for the DVLA re diabetes, however when I contacted them they INSISTED that I had to inform them although I am diet only, but that it needed to be on record although they did not want to change my license. Go figure!

I was also trying to find the bit where it said about DVLA and testing before driving but couldn't find it - is that "just" the NICE recommendation backed by DUK or is it actually on the DVLA website somewhere??


Alice

Hi Alice.
No accounting for staff.....? This is the up to date information from the actual DVLA website -not the Directgov site.

You DO NOT have to notify the DVLA if you are on tablets or diet only.

Regardless of what you were told. If they tell you that again, tell them to check their own regulations ! The information is very clear.

Here is the link to the actual Medical Advice guide for Medical Practitioners which gives the correct information. It was updated September 2009. Maybe the person you spoke to hadn't updated their own database ? Just download the pdf for the full document.
http://www.dft.gov.uk/dvla/medical/ataglance.aspx

Form INF 188/2 Information for drivers of cars or motorcycles with Diabetes treated by tablets, diet or both. Please keep this leaflet safe so you can refer to it in the future.
Drivers do not need to tell DVLA if their diabetes is treated by tablets, diet or both and they are free of the complications listed below
Some people with diabetes develop associated problems that may affect their driving.
What you need to tell us about
By law you must tell us if any of the following apply:
you need treatment with insulin.
you need laser treatment to both eyes or in the remaining eye if you have sight in one eye only.
you have problems with vision in both eyes, or in the remaining eye if you have sight in one eye only. By law you must be able to read, with glasses or contact lenses if necessary, a car number plate in good light at 20.5 metres (67 feet) or 20 metres (65 feet) where narrower characters 50mm wide are displayed.
you develop any problems with the circulation or sensation in your legs or feet which make it necessary for you to drive certain types of vehicles only, for example automatic vehicles or vehicle a hand operated accelerator or brake. This must be noted on your driving licence.
HYPOGLYCAEMIA
The risk of hypoglycaemia (low blood sugar) is the main hazard to safe driving and can occur with diabetes treated with insulin or tablets or both. This may endanger your own life as well as that of other road users. Many of the accidents caused by hypoglycaemia are because drivers continue to drive even though they are experiencing warning signs of hypoglycaemia. If you experience warning signs of hypoglycaemia while driving you must always stop as soon as safely possible – do not ignore the warning signs.
You must inform DVLA if:
you suffer more than one episode of disabling hypoglycaemia (low blood sugar) within 12 months, or if you or your carer feels you are at high risk of developing disabling hypoglycaemia.
you develop impaired awareness of hypoglycaemia. (difficulty in recognising the warning symptoms of low blood sugar)
you suffer disabling hypoglycaemia while driving.
an existing medical condition gets worse or you develop any other condition that may affect you driving safely.
In the interests of road safety you must be sure that you can safely control a motor vehicle at all times.How to tell us
If your doctor, specialist or optician tells you to report your condition to us, you need to fill in a DIAB1 medical questionnaire about diabetes.
You can download this from http://www.direct.gov.uk/driverhealth
Phone us on: 0870 600 0301
Write to: Drivers Medical Group, DVLA Swansea SA99 1TU
E-mail: eftd@dvla.gsi.gov.uk


As regards the testing and driving advice from the DVLA it is in the document, but really relates to those on Insulin/Byetta/Victoza or who are holders of a Group 2 (LGV) licence. It does get complicated I'm afraid.

I had to negotiate this stuff on a daily basis for years and even I get confused sometimes. :?

All good stuff, but as we all know "DVLA are never wrong..." Go figure... :roll: :lol:

Thanks - the information is the same as one link to the DVLA page, but didn't know where that testing after two hours when driving, came from - so thanks for clearing that up. The NICE guidelines does indeed mention testing and driving for T2, but it is actually not a requirement or recommendation from the DVLA for T2 diabetics. "Only" to ensure one can "safely operate a motor vehicle at all times".

And you are right - it does get complicated and unnecessarily so, sadly.


Alice