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Driving Licence Help Needed

D

Daffy

Newbie
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Since I changed from Actrapid to NovaRapid I now have no indications of a hypo so my levels can get down to 1.7 without me having any obvious side effects. My employer has contacted my GP and they have advised that due to this I can no longer do any driving related to work and after meeting with my GP yesterday to discuss he said that my licence will not be renewed next year unless there are significant changes.
I have been like this for the last 18 months and have tried running my levels high for a week to try and 'reset' my body to recognise hypos but with no success. When on the actrapid I had all the symptoms when my levels hit about 4 shakes, blurred vision etc.
I have a couple of questions. The Occupational Health that carried out the work for my employer say I should not be driving full stop. Is my GP obliged to inform DVLA of this now or when my licence is due for renewal? Or do I have to notify DVLA now? Does anyone else have this problem with Nova Rapid? My GP says that Actrapid is now no longer produced and this was why he changed it 18 months ago.
I am a bit confused as although I knew I had a bit of a problem I did not think things were that bad, on reflection possibly they are. Any advice greatly appreciated as I really don't want to give up my licence as cars and driving are my biggest passion.
 
Not sure how this works really but did your GP not suggest switching to something else as surely, regardless of the driving, hypo unawareness could cause you all sorts of problems? This could possibly resolve your driving situation too.

I am new to all this and no expert but I would of thought this would have been a logical move.

The others on here have loads of experience and advise to offer and I am sure will be of help.

Hope it all works out for you

Louise
 
Hi Daffy

I dont think yr GP is correct when he says that Actrapid is not available anymore. As far as I know, my friend still uses it.

In any case, animal insulin is still being produced from http://www.wockhardt.co.uk/animal-insulin/index.asp and that will be more or less the same as Actrapid in its action giving you better hypo awareness.

Yr GP is being a bit naughty in not helping you acheive better hypo control. Can I ask what background insulin you are using at the moment? If you are using Lantus, then a change to Levemir will probably help as its a bit more gentle in its action.
 
iHs said:
Hi Daffy

I dont think yr GP is correct when he says that Actrapid is not available anymore. As far as I know, my friend still uses it.

In any case, animal insulin is still being produced from http://www.wockhardt.co.uk/animal-insulin/index.asp and that will be more or less the same as Actrapid in its action giving you better hypo awareness.

Yr GP is being a bit naughty in not helping you acheive better hypo control. Can I ask what background insulin you are using at the moment? If you are using Lantus, then a change to Levemir will probably help as its a bit more gentle in its action.
Click to expand...

My control is pretty good it is just the fact that I have no indicators of a hypo and the cause of them is mostly unknown.
IIRC my base insulin is Glargine but until I get home to check I can't be sure. It is in a purple and white box with a purple lid.
Sorry my Actrapid was human actrapid not sure if there are different versions such as animal based ones.
 
When I went on the pump, I coincidentally changed from novorapid to apidra. I have become more hypo aware since then. (could be the pump or the insulin).
As to 'resetting' through running higher I understood it took longer than a week. This is the advice from the hospital in Birmingham
If you have hypo unawareness and have low sugars without knowing, this indicates you are probably getting frequent hypos, with the result that your body's reaction to them wears off.
To correct this you really need expert advice from you diabetes specialist nurse, but this is what one patient was advised (see example 12 below)

reduce most of your insulin doses 2-4 units
test frequently, 6 times a day
your tests should then reveal no hypos, otherwise you may have to reduce your insulin more
when your body adjusts to the higher sugar levels, perhaps in a 2 weeks or so, you should start to recognise hypos again. You need to keep testing your sugar levels.
Gradually increase your insulin levels so that your sugar reaches reasonably low levels, but not the very low hypo levels you had before
Click to expand...
http://medweb.bham.ac.uk/easdec/prevention/HBA1c & type 1 diabetes.htm#unawareness2
 
with that unawareness you shouldn't be driving and should inform the DVLA straight away.

You can still get actrapid, i'm pretty sure there will always be actrapid as we use so much in hospital. what i think is the case is that it doesn't come in cartridges or pen form anymore but you can get it in vial. So if you are happy to use syringes then ask for actrapid to be prescribed.
 
Do you inject the glargine (Lantus) once a day before bed or use it twice?

Often insulins can be balanced up by experimenting a bit and altering the ratios of basal to bolus. You might be having too much basal and that is what is causing your unawareness. There is no perfect dose as we are all different but if you are able to test frequently, then you should be able to adjust the bolus/basal and get your ideal combo.

Although its unwise for you to drive whilst being like you are, there is no need at the moment for you to notify the DVLA as youve not been involved in an accident as a result of going hypo. With some change to your insulin regime, you should be able to get your awareness again.

Just make sure that youve always got some sweets or glucose tabs to nibble. Its better to go a bit high and correct yourself at the end of the journey, than it is to be bordering on being low and be at risk to yourself and other people.
 
Don't even both going as far as the DVLA imo. Get yourself off it, use whatever stockpile you have of actrapid until your doc gets you on a replacement like Humulin S.
 
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