Driving.

Hi @Jc3131 ,

I never underestimate what can happen with BS levels whilst driving.

What insulin regime are you currently on? How long diagnosed? (just to get a gauge on where you are at with "Not fully yet.")

We are all different. I know by now - with a reasonable level of confidence - that 1 unit of insulin will drop me about 3 to 4 mmol.

So if I'm above 10 mmol at a mid-journey stop I will inject again. So all things being equal I will still be above 6 mmol once the insulin has done its work.

'BUT' I always keep a couple of bottles of Glucojuice in the car for when things go wrong.

I suspect the nerves involved in your first big drive created your high levels. Stress is the big unknown with these things. I am sure it will get easier the more relaxed you are.

urbanracer said:

We are all different. I know by now - with a reasonable level of confidence - that 1 unit of insulin will drop me about 3 to 4 mmol.

So if I'm above 10 mmol at a mid-journey stop I will inject again. So all things being equal I will still be above 6 mmol once the insulin has done its work.

'BUT' I always keep a couple of bottles of Glucojuice in the car for when things go wrong.

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Sorry i know this is going off on one but I'm surprised at how much you drop. It seems I drop 1.5 for 1 unit. Is my insulin dodgy?

Hi @Jc3131, not so many speed cameras here but as someone who is still honeymooning and drives regularly through the week I thought I'd mention a few things that I do. I also seem to be really sensitive to insulin although my doses are a little higher than yours so hopefully we're not too far from comparable.

First thing I adjusted long term is my target range (with agreement from my DSN) to between 5-8 usually instead of 4-7. This helped with having to snack before driving as snacking because of a 4.x result was irritating me no end. Changes made ended up being a combination of tweaking basal so it wasn't too aggressive over the course of the day and discovering what tends to happen at different times of the day. For example; providing I go to bed with a reasonable number (6.0~7.0) and no fast acting on board I can reasonably expect most of the time to wake up in that area and rarely closer to 5.0. This helps with commuting in the morning, especially if I skip breakfast which sometimes happens as I'm not always hungry first thing.

I'm extremely wary with corrections in the early evening through to midnight as this seems to be a particularly sensitive time for me and the drops can be massive (all the way up to 5.7mmol per 1U). This has been put down to honeymoon and a bit of a helping hand on the way down that can land me in trouble if not careful. I have a half unit pen to help me manage this and it's been incredibly useful so if you don't have one for your quick acting it may be worth asking if you can from your team.

I also identified that late afternoon (16:00 onwards) I seem to get a slide downwards in blood glucose no matter where it's at if I've been reasonably active so depending on my post lunch test result (I usually have lunch after 13:00 during the week) I'll have a biscuit/small apple/snack between 10-15g carbs to counter it instead of reducing dose at lunch.

Driving itself; if I'm doing multiple short journeys or one longer one within the 2 hours I will try and do a test up to 15 minutes before getting behind the wheel to make sure I don't need a nudge and prevent delays. For longer journeys traversing the country I will stick to right before driving and have a small amount of carbs if below 6.0. I'll then use up much of the 2 hours before retesting unless I feel anything is not quite right in which case I pull up safely and check.

It can be frustrating at times and it's one of the biggest bugbears/hurdles/pains in the neck I've encountered since diagnosis but I take it extremely seriously as my licence is very important to me.

SueJB said:

Sorry i know this is going off on one but I'm surprised at how much you drop. It seems I drop 1.5 for 1 unit. Is my insulin dodgy?

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Probably not if your doses for meals are working. Though if you suspect it is then try changing the pen. Remember we're all different and react to things differently. My correction sensitivity ranges between 4.0~5.7mmol per 1U over the course of day and night. My ratios don't match up with this though so the maths/formulas don't work great for me.

You just get used to it...sure iits a bit worrying to start with..remember to check bg before you start driving ..and obviously if you get any of the signs of a hypo whilst driving pull over and check...youll be fine ..happy motoring

It ain't easy that's for sure, my job entails me jumping in a car at any random moment and driving at speeds. That means I have to try to keep my levels on a permanent 'high' whilst at work so that I can respond to things quickly. That is blooming hard because it means eating snacks all day long whether I want them or not.

SueJB said:

Sorry i know this is going off on one but I'm surprised at how much you drop. It seems I drop 1.5 for 1 unit. Is my insulin dodgy?

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Can't tell if your insulin is OK @SueJB , but your body will react differently to mine when it comes to insulin.

If I'm having a lazy day at home I can inject several units and not see any movement in blood glucose levels. For me, it's also massively related to activity levels.

I drive all year round but ride a motorbike in warmer weather. Looking forward to the ease of scanning my Libre this summer instead of fingerpricking cold fingers, I just hope it works through very thick cowhide!

To me, driving is part of life.
So I learn how to manage my BG through trial and error.
As others have suggested, as I got use to driving with diabetes and worrying less, it has less impact on my BG. Sure, if I get stuck in a long traffic jam which means I may miss my meeting/flight/friends, I get a bit stressed but this has little to do with the driving: more a social dislike of lateness.

As required by the DVLA, I test approximately every 2 hours and make the necessary corrections.
Sometimes, this is a pain and I may stretch the 2 hours if I am close to my destination.

Unfortunately, the DVLA are a little behind the times and still require a finger prick which means Libre and CGM users can't "just scan" during a long journey: they still have to stop and draw blood.

helensaramay said:

Unfortunately, the DVLA are a little behind the times and still require a finger prick which means Libre and CGM users can't "just scan" during a long journey: they still have to stop and draw blood.

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You can scan between blood tests though, to get an easy indication of what’s going on

I have been driving ever since I was diagnosed type 1 in 1984. It has never bothered me once. I always make sure that I have fast acting "something" in the car in case my blood levels get low and for the last 3 years I have been using the Freestyle Liibre system which makes testing even easier when driving. I was a policeman at the time I was diagnosed and the only jobs I was restricted from doing was the Traffic and Marine departments for obvious reasons.
Can we please clarify something once and for all. People state that it is a legal requirement by the DVLA for Type !'s to blood test before and during driving. As far as I can ascertain, it is not. It is strongly suggested that we do and I fully agree, but it is not the law. I have spoken to several Police traffic patrol officers and they all agree that there is nothing in law that states that. There is no offence that you can commit and there is no punishment that can be given. The DVLA contradict themselves in their own literature about this point. When applying on line to re-new your licence it states that it is a legal requirement to test but in the paper version it states it is suggestion. I have also spoken to the DVLA asking them which legislation covers this but they will not or can not tell me. Now you can commit an offence through driving whilst unfit through drink or drugs and it has been argued that if you drive when your bloods are too low and have an accident, then you may come into this category. The obvious answer is yes, test before and during long drives, but don't be bullied by the DVLA.
If anyone knows better or can show me which law you would break if you don't test, then I will be the first to apologise.

Copernicus said:

I have been driving ever since I was diagnosed type 1 in 1984. It has never bothered me once. I always make sure that I have fast acting "something" in the car in case my blood levels get low and for the last 3 years I have been using the Freestyle Liibre system which makes testing even easier when driving. I was a policeman at the time I was diagnosed and the only jobs I was restricted from doing was the Traffic and Marine departments for obvious reasons.
Can we please clarify something once and for all. People state that it is a legal requirement by the DVLA for Type !'s to blood test before and during driving. As far as I can ascertain, it is not. It is strongly suggested that we do and I fully agree, but it is not the law. I have spoken to several Police traffic patrol officers and they all agree that there is nothing in law that states that. There is no offence that you can commit and there is no punishment that can be given. The DVLA contradict themselves in their own literature about this point. When applying on line to re-new your licence it states that it is a legal requirement to test but in the paper version it states it is suggestion. I have also spoken to the DVLA asking them which legislation covers this but they will not or can not tell me. Now you can commit an offence through driving whilst unfit through drink or drugs and it has been argued that if you drive when your bloods are too low and have an accident, then you may come into this category. The obvious answer is yes, test before and during long drives, but don't be bullied by the DVLA.
If anyone knows better or can show me which law you would break if you don't test, then I will be the first to apologise.

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Firstly, the suggestion/recommendation/legality refers to any person with diabetes taking medication which may lower their BG. Not just type 1.
Secondly, whether it is law or not, I would have thought it is good practice however long the journey is. I do not feel I am being bullied by the DVLA or anyone else about how to drive safely.

Copernicus said:

I have been driving ever since I was diagnosed type 1 in 1984. It has never bothered me once. I always make sure that I have fast acting "something" in the car in case my blood levels get low and for the last 3 years I have been using the Freestyle Liibre system which makes testing even easier when driving. I was a policeman at the time I was diagnosed and the only jobs I was restricted from doing was the Traffic and Marine departments for obvious reasons.
Can we please clarify something once and for all. People state that it is a legal requirement by the DVLA for Type !'s to blood test before and during driving. As far as I can ascertain, it is not. It is strongly suggested that we do and I fully agree, but it is not the law. I have spoken to several Police traffic patrol officers and they all agree that there is nothing in law that states that. There is no offence that you can commit and there is no punishment that can be given. The DVLA contradict themselves in their own literature about this point. When applying on line to re-new your licence it states that it is a legal requirement to test but in the paper version it states it is suggestion. I have also spoken to the DVLA asking them which legislation covers this but they will not or can not tell me. Now you can commit an offence through driving whilst unfit through drink or drugs and it has been argued that if you drive when your bloods are too low and have an accident, then you may come into this category. The obvious answer is yes, test before and during long drives, but don't be bullied by the DVLA.
If anyone knows better or can show me which law you would break if you don't test, then I will be the first to apologise.

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Hi...not trying to be argumentative but your remarks are merely your opinion, being a policeman does not qualify u to 'clarify' the law or give legal advice...it depends what class of lisence you hold as to what dvla can do to you . Hgv and bus drivers are checked annually and records have to be supplied...recently a driver i know lost his hgv lisence because he failed to take a blood glucose reading ON HIS DAY OFF !!!..dvla are always trying to intimidate drivers and like to think they wield control over us....funny though when a driver run down and murdered six people they did nothing to him even though he failed to declare a medical condition which would have barred him from driving.!!!.

james11 said:

Hi...not trying to be argumentative but your remarks are merely your opinion, being a policeman does not qualify u to 'clarify' the law or give legal advice...it depends what class of lisence you hold as to what dvla can do to you . Hgv and bus drivers are checked annually and records have to be supplied...recently a driver i know lost his hgv lisence because he failed to take a blood glucose reading ON HIS DAY OFF !!!..dvla are always trying to intimidate drivers and like to think they wield control over us....funny though when a driver run down and murdered six people they did nothing to him even though he failed to declare a medical condition which would have barred him from driving.!!!.

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Hi James, I wasn't giving legal advice but this is more than just my opinion, I have made enquires as stated in my post and no one can tell me what, if any offence, would be committed by not testing before driving. I absolutely agree that you should test, I just object to being lied to and threatened by the DVLA in this matter. I repeat, there is no offence in any of the road traffic laws that disprove this.I completed a DAFNE course a few years ago and at the end of it I asked the consultant if type 1's had to blood test before driving and he said no, it wasn't law but it was advisable which I agree with. I hold a full UK licence with no restrictions and the only difference is I have to apply every three years for a new one.

Copernicus said:

Hi James, I wasn't giving legal advice but this is more than just my opinion, I have made enquires as stated in my post and no one can tell me what, if any offence, would be committed by not testing before driving. I absolutely agree that you should test, I just object to being lied to and threatened by the DVLA in this matter. I repeat, there is no offence in any of the road traffic laws that disprove this.I completed a DAFNE course a few years ago and at the end of it I asked the consultant if type 1's had to blood test before driving and he said no, it wasn't law but it was advisable which I agree with. I hold a full UK licence with no restrictions and the only difference is I have to apply every three years for a new one.

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Hi..i guess we are all hood winked under threat more than we realise by those in 'authority' ....just read my latest dvla letter 12/4/18...it says "as you are aware, it is a legal requirement to undertake bg monitoring at leasst twice daily" however it does not state which law but when explaing my right to appeal decision it does state the law regarding that...!!!!.. i will phone dvla and query it myself in the near future and let you know if they can come up with the answer.

Copernicus said:

I have been driving ever since I was diagnosed type 1 in 1984. It has never bothered me once. I always make sure that I have fast acting "something" in the car in case my blood levels get low and for the last 3 years I have been using the Freestyle Liibre system which makes testing even easier when driving. I was a policeman at the time I was diagnosed and the only jobs I was restricted from doing was the Traffic and Marine departments for obvious reasons.
Can we please clarify something once and for all. People state that it is a legal requirement by the DVLA for Type !'s to blood test before and during driving. As far as I can ascertain, it is not. It is strongly suggested that we do and I fully agree, but it is not the law. I have spoken to several Police traffic patrol officers and they all agree that there is nothing in law that states that. There is no offence that you can commit and there is no punishment that can be given. The DVLA contradict themselves in their own literature about this point. When applying on line to re-new your licence it states that it is a legal requirement to test but in the paper version it states it is suggestion. I have also spoken to the DVLA asking them which legislation covers this but they will not or can not tell me. Now you can commit an offence through driving whilst unfit through drink or drugs and it has been argued that if you drive when your bloods are too low and have an accident, then you may come into this category. The obvious answer is yes, test before and during long drives, but don't be bullied by the DVLA.
If anyone knows better or can show me which law you would break if you don't test, then I will be the first to apologise.

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I would concur that there are no figures for glucose levels written in statute. At least I have not been able to find them during several previous on-line searches. The underlying principal of course is 'Fitness to Drive' and how it is assessed.

The Secretary of State's Medical Advisory Panel sets recommendations for group 1 drivers and requirements for group 2 drivers.

However, I think this misses an important point. When an insulin dependant diabetic applies for a license to drive, the second question asked (either on line, or on the printed form) is.....

"I agree to test my blood glucose at times relevant to driving. Times relevant to driving means no more than 2 hours before the start of your journey and every 2 hours whilst driving."

The applicant ticks either the YES or NO box. (I'm assuming that no person here has ticked NO and still managed to get a license?)

At the end of the process the applicant will sign a declaration that the information provided is correct and thereby enter into a legally binding contract with the DVLA. Whether there is a law to govern blood glucose monitoring then becomes largely irrelevent.

My understanding then is that if after obtaining the license to drive, the applicant did not test glucose levels it would mean that the license was obtained under false pretences and would be invalidated.