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Five To Drive?

Discussion in 'Diabetes Discussions' started by Shannon27, Sep 13, 2017.

  1. Shannon27

    Shannon27 Type 1 · Well-Known Member

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    Hi everyone!
    I've heard about this NICE guideline for drivers, five to drive. Thing is, if I tested before I went for a long drive (the 50 mile journey between work and home for example) and my readings were 5, I would not feel comfortable driving until I'd eaten and was between 7 and 8. After all, 5 is only one mmol off being hypo!
    Does this guideline mean that it's ok to set off driving at 5 without eating anything beforehand? Because it's totally NOT (in my experience at least). Or does it mean that after eating something you must wait until being at least 5 to set off? It just concerns me that some people may be seeing the guideline and believe its ok. If it were 6 or 7 to drive, it would be less risky, but 5?
    Just looking for some confirmation / information on this guideline, if anyone could reply with anything or share experiences then that would be great!
    Thanks
    Shannon x
     
  2. Amy993

    Amy993 Type 1 · Well-Known Member

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    I only passed my driving test on Saturday, so am new to it. But if i am at 5, or slightly under i will set a temporary basil for the time period i am driving, and the amount depends on what i have been doing. If i am low 4's i will set a temporary basil and eat something too
     
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  3. db89

    db89 Type 1 · Well-Known Member

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    Hi @Shannon27, I discussed this with my DSN after being diagnosed as it was one of my concerns (I like driving and I do a decent amount most days). At the time my concern was mainly based around: if I were to get a 5.3 at 17:00, that is a snapshot at that moment. I don't have a Libre or CGM so I don't know whether that is 5.3 and stable, heading up or down.

    We decided to set a target range throughout the day of 5-8 rather than the 4-7 I'd originally been working towards and this has mainly been working well for me. As far as I understand it you are actually allowed to drive if slightly below 5.0 if you have a small carby snack beforehand. Personally, I like to make sure I am closer to 6 than 5 before I will drive anyways and if I am close to the lower limit (even though technically deemed legal) I will still have something small (and likely made of slower acting carbs) to nudge it back up for the journey.

    Edit: I suspect (but have nothing to confirm) that the guidelines are based around a number of assumptions including:
    • Your basal insulin is working effectively and keeping you fairly flat throughout the day.
    • You are able to determine when you still have active bolus insulin on board and can make a decision based on the test about what is currently happening before setting off.
     
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    #3 db89, Sep 13, 2017 at 3:31 PM
    Last edited: Sep 13, 2017
  4. Shannon27

    Shannon27 Type 1 · Well-Known Member

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    Belated well done @Amy993 :D
     
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  5. Shannon27

    Shannon27 Type 1 · Well-Known Member

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    This seems ideal for driving with! I generally don't carry food around in my car with me, mainly because I'm a greedy guts and will probably snack mid morning if I had it, with correction based on my readings :p I always have a full bottle of lucozade with me though which works wonders!
     
  6. GrantGam

    GrantGam Type 1 · Well-Known Member

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    I think what you're referring to is clarification on the following guidance?:

    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.

    Having a snack is purely guidance, sensible guidance at that. Although it's not illegal to drive "on an empty stomach" with a BG of 4.6mmol/l for example.

    What is illegal however is being behind the wheel, or in control of a vehicle whilst being in a hypoglycemic state.

    I don't think it's personally all that risky setting off at 5mmol/l to drive, but then it's entirely dependant on your level of control. I'd normally have a swig of lucozade or the like at 5mmol/l, just to give me a little cushion in the event that my BG were to trend downwards whilst driving.

    Just to clarify on what you've asked:

    -It is absolutely legal to set of driving at 5mmol/l without eating something.
    -You can legally drive with any BG value >/=4mmol/l

    https://www.gov.uk/government/uploa...o-drive-a-guide-for-medical-professionals.pdf
     
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  7. Daibell

    Daibell LADA · Master

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    It can be very difficult to know exactly what to do when about to drive and your BS is quite low. If I'm between 4 and 5 I will consider when I last had my Bolus and whether that has now 'finished'. If so I will have some glucose tablets (always in the car) and drive; assuming I feel fine. If my Bolus may still be acting I will have several glucose tablets, wait 10-15 minutes and re-test. It has to be a judgement thing but I always have some carbs anyway if I'm below 5 to reduce risk. If I'm only a little over 5 I will also consider whether I may go lower whilst driving
     
  8. Ann1982

    Ann1982 Type 2 · Well-Known Member

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    It's a difficult one isn't it? I always test beforehand and I always have a spare meter and hypo kit in the car just in case. Fortunately haven't had to use them .
     
  9. azure

    azure Type 1 · Expert

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    I like to be above 6 to drive. If I'm about to start a long journey, I'd think carefully about having a snack even if I was 5.

    Better to run slightly higher in the car than risk killing yourself or others.
     
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  10. Deleted Account

    Deleted Account · Guest

    I think it is about knowing how your body reacts and interpreting the DVLA guidelines appropriately
    In the right conditions, the DVLA recommendations are fine most of the time but I can think of situations when the guidelines make little sense.
    - If it is some time since eating, I have no IOB and I have not been doing anything to lower my BG (e.g. exercise), I trust my basal setting not to reduce my BG further. So I am happy to drive with a BG of 5.0 (probably not lower).
    - If I have IOB and a BG of 5.0, I will consider when and what I last ate. Then take a view.
    - If I have just been exercising, I aim for a BG of above 6.0.

    The DVLA doesn't give any guidelines about high BG. But I know driving with a high BG could be dangerous for me: blurred vision, feeling lethargic, dying for a wee, ...
     
  11. noblehead

    noblehead Type 1 · Guru
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    I would eat a small snack at 5mmol/l but wouldn't wait until I was between 7-8 as I know the snack would raise my bg anyway, this would be especially so if I was travelling from work to home (as in your example) and would have very little active insulin on board from the previous bolus dose.

    Usually I like to be around 6 or above before setting off on a longish journey.
     
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