CGM and getting driving licence back

i thought you lost it permanently

I think @catapillar might have some knowledge about this

I don't know. My driving licence was surrendered because I don't have hypo awareness and I thought surrendering it would make it easier to get it back if hypo awareness was regained rather than having it revoked.
Its not 3 months no hypo awareness that you need to get your licence back, it's regained hypo awareness. If you can get your consultant to confirm that you have adequate hypo awareness then you may have a chance at regaining your licence. Obviously if you're relying on the cgm to warn you of hypos that's not hypo awareness - you need to be having reliable warning symptoms.

Tracey167 said:

Hi all
It's been a while since I've been on diabetes forum. I got my CGM from the hospital nearly a month ago now as I lost all my hypo awareness in 2006 and it's is doing a great job I am so pleased with it. I had my driving licence revoked in 2010 for having no hypo awareness and just wondered how long I would have to wait to re-apply to the DVLA for it back now I have my CGM monitor. I was told when my licence was revoked that I would have to go 3 months with no low glucose levels which for a type 1 is very hard especially with no hypo awareness.

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I Tracy, I doubt any type 1 unless running high all the time would be able to go 3 months without a hypo.
The issue is hypo awareness if you have none then for obvious reasons you can not hold a driving licence. CGM's are not recognised by the DVLA for monitoring blood sugars either. So I hope you have your warning signs back and are soon on the road again.

Tracey167 said:

Hi thanks for your replies. Yes I suppose DVLA are not going to recognize what a CGM is and obviously my hypo awareness has not returned. I will ring DVLA and ask them that's probably the easiest thing to do. The CGM is set to alert me when my levels reach 5.0mml and will go off every 5 mins until my levels go above 5.0mmol.

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Hi Tracy the CGM reads about 20 mins behind your actual finger poke test. It's written in stone no hypo awareness so no licence A CGM is no fail proof either so do be warned.

I would recommend not driving until you manage to regain hypo awareness. CGMs can help, but in my experience they miss low/dropping blood sugars far too often to rely on them completely. They have issues with accuracy, and can also lag behind your true blood sugar if it is changing quickly. When I am driving, I rely on my own body more than any of my machines. If I don't feel right, I won't drive (even if the CGM says I meet the "above 5" criterion). Also, you still need to do finger pricks since CGM values don't count legally. If you had an accident the reading from your CGM would not be sufficient proof that you were safe to drive (At least that's what I was told by the educator).

CarbsRok said:

It's written in stone no hypo awareness so no licence A CGM is no fail proof either so do be warned.

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I'd have thought that too

You can't check a cgm and drive in the same way that you csn't text and drive. Alarms are fine but they depend on the cgm being accurate and up to the minute. The first is not always true from my experience and the 2nd is never true. Get hypo awareness back with the help of the cgm which will help you see your trends and how to alter things for best control and then you will get your driving licence back. I know it's a complete pain but it's better than being responsible for killing yourself or others.

Not that this is legal or safe….

But what do people think of running their BG over 6 with an alarm set at 6 so as to reduce the risk of not having hypo awareness?

I also expect that doing the above 24/7 responding whenever BG goes below 6 will increase hypo awareness, but may also increase the risk of going blind etc……. (Low carb can limit the how high the peaks are above 6 to provide some protection from gong blind etc.)

Have a look at the average bs needed to get an in range hba1c. It's higher than 6. No one knows for sure why some people have complications and others don't. All they can say is statistically those with higher hba1cs do. However an hba1c is an average it can hide large spikes and drops. There's a school of thought currently that the consistency of constant in range readings at a higher level is more important if you can generally avoid massive spikes. Reality is no one knows and there's no guarantees. Have a bad hypo behind the wheel you have a much higher certainty of injuring/ killing yourself or others. A bad hypo can also kill/cause brain damage too. Do your best to walk the tight rope and don't mess with DVLA. That is a sure way to lose a licence.

ringi said:

Not that this is legal or safe….

But what do people think of running their BG over 6 with an alarm set at 6 so as to reduce the risk of not having hypo awareness?

I also expect that doing the above 24/7 responding whenever BG goes below 6 will increase hypo awareness, but may also increase the risk of going blind etc……. (Low carb can limit the how high the peaks are above 6 to provide some protection from gong blind etc.)

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Without thinking; on a recent visit to my GP I showed her a list of my BG measurements. Some of the measurements listed were 3.5, 3.8 and 3.9 mmol/L. My GP subsequently advised the DVLA that I was prone to hypos without been aware of having a hypo (below 4.0mmol/L)

I disregarded these figures at the time as they looked like meter error as most meters are usually rated as only plus / minus 15% accurate. At the time of the readings my driving licence was on hold anyway so the issue of driving wasn’t a consideration. A low meter reading wasn’t an issue pottering around at home so left it.

I am now in a position where I have to convince the DVLA that this so called hypo unawareness may have been a meter error! I don’t think my doctor had the vaguest idea these meters are not very accurate. (especially on a reading of 3.9!)

I would guess there should be a crib sheet of what to do if meter gives a reading below 4.0mmol/L and what to do if you drive.

Does anyone know of this?


PS The opposite situation could also occur; if you get a reading of 4.5mmol/L you could be under 4.0!! (less 15% is 3.8).

Maybe one partial answer is to retest with a different branded meter and different test strips (the error could be a batch of dodgy test strips)

To add to my previous message; I did read up on hypo unawareness. The idea of having a BG measurement of below 4mmol/L as showing a hypo is not true. It’s just an indicator of a POSSIBLE hypo (to most people). Some people can be as low as 3.3 and still not have a hypo, others may get a hypo at 5.6! 1)

Which leads to the question then; just what is a hypo if it’s not determined by just a measurement of BG? From what i’ve read; a hypo has another name... “sugar drunk”. The symptoms being similar to “alcohol drunk”.

What I think people mean by being “hypo unaware” is being “sugar drunk” without realising the tell tail symptoms. This is especially an issue in people who develop a tolerance to hypos over a few years i.e. usually type 1.

This is just the same with people having 3 double whiskies then been “alcohol drunk” without realising. They then think they are ok to drive. In reality; their reaction times are way below what’s needed to drive or operate machinery.

Perhaps a good saying to remember is; “Below 5; don’t drive”. i.e. make sure you get a reading above 5 before even thinking about driving. This will give you a reasonable safety margin (for most people)


Ref 1) https://www.uptodate.com/contents/h...-sugar-in-diabetes-mellitus-beyond-the-basics