I don't get it..

If I got put onto insulin as the law stands at present I WOULD lose my job and 2 of my licences (Lorry and Coach) along with my Taxi Badge and so I would be very anti the idea until the law hopefully gets changed later in the year as T1s are at present not allowed to drive any of these category vehicles!!
Thus as long as I am able to control by diet and tablets I will.
Angie[/quote]
Wow! Thanks for sharing your experience, Angie. Again in the linked document Bowell posted I don't see the legal standing for that. So I'm still wondering where I can read about it and see the exact wording. If it's law - then it's a silly law. But the US has some of those too. :-([/quote]

Don't know where the wording is actually written down but more info can be found here...
http://www.diabetes.co.uk/driving-for-w ... vices.html

When I was diagnosed as a type 2 with a level of 25 they could have sent me straight to hospital and started me on insulin there and then.....consequently I would have effectively been made unemployable overnight in my line of work....quite a scary thought. Fortunately my nurse knew me and my job and took a chance that I would do as I should dietwise and that the tablets would work. Thankfully her gamble paid off.
Angie

angieG said:

NewdestinyX said:

angieG said:

If I got put onto insulin as the law stands at present I WOULD lose my job and 2 of my licences (Lorry and Coach) along with my Taxi Badge and so I would be very anti the idea until the law hopefully gets changed later in the year as T1s are at present not allowed to drive any of these category vehicles!!
Thus as long as I am able to control by diet and tablets I will.
Angie

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Wow! Thanks for sharing your experience, Angie. Again in the linked document Bowell posted I don't see the legal standing for that. So I'm still wondering where I can read about it and see the exact wording. If it's law - then it's a silly law. But the US has some of those too. :-(

Click to expand...

Don't know where the wording is actually written down but more info can be found here...
http://www.diabetes.co.uk/driving-for-w ... vices.html

When I was diagnosed as a type 2 with a level of 25 they could have sent me straight to hospital and started me on insulin there and then.....consequently I would have effectively been made unemployable overnight in my line of work....quite a scary thought. Fortunately my nurse knew me and my job and took a chance that I would do as I should dietwise and that the tablets would work. Thankfully her gamble paid off.
Angie

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Thanks for the other article I will read it carefully. Still something doesn't sit right with me about this notion of it being against the law to be a driver while on insulin. But I have to take the word of people that live there when I don't. Thanks!

Should keep you busy for a bit
You can also down load the medical forms Things are changing in OCT

Changes to the standards for driving Group 2 vehicles (buses and lorries)
http://www.dft.gov.uk/dvla/medical/Annex 3 changes to diabetes.aspx

From October 2011, to be able to apply for entitlement to drive Group 2 vehicles, applicants will have to meet the following standards when treated with insulin. When treated with medication other than insulin which carries a risk of inducing hypoglycaemia (including sulphonylureas and glinides), the following standards have applied since September 2010.

There has not been any severe hypoglycaemic event in the previous 12 months
The driver has full hypoglycaemic awareness
The driver must show adequate control of the condition by regular blood glucose monitoring, at least twice daily and at times relevant to driving*
The driver must demonstrate an understanding of the risks of hypoglycaemia and
There are no other debarring complications of diabetes

*To demonstrate adequate control of the condition by regular blood glucose monitoring, the Secretary of State's Honorary Medical Advisory Panel on Diabetes Mellitus (the Panel) has recommended that applicants with insulin-treated diabetes will need to have used blood glucose meters with a memory function to measure and record blood glucose levels for at least three months prior to submitting their application.

The requirement to demonstrate three months of blood glucose monitoring before applying for a Group 2 licence is already a requirement of the current C1 licensing process for drivers with insulin- treated diabetes. The additional requirement to demonstrate monitoring using a blood glucose monitor with a memory function is considered by the Panel to be an appropriate additional requirement to balance the desire to increase opportunities for those affected whilst ensuring the country's excellent road safety record. We would be grateful if you would make this clear to any of your patients who are considering applying for Group 2 licensing.

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http://www.dft.gov.uk/dvla/medical/ataglance.aspx

http://www.direct.gov.uk/en/Motoring/DriverLicensing/MedicalRulesForDrivers/MedicalA-Z/DG_185427

The American Diabetes Association also has information about Commercial Drivers... there used to be a blanket ban if on insulin but since 2003 special exemptions can be given if you meet the criteria...

http://www.diabetes.org/living-with...nd-diabetes-discrimination/general-questions/

what is puzzling about this concept?

Grant lets turn this around

We will say in the US that YOU could no longer hold a full driving license more than 3 years
then a medical to prove that in last year you had NO Hypos :shock: (1 and your out)
A flat ban on insulin users who can no longer drive a taxi bus or truck
Tow a trailer or boat

Would that make you think twice before you took the insulin :roll:

Not so clever your side ether Grant :wink:

From your FMCSRs. Site
http://www.fmcsa.dot.gov/rules-regulations/administration/medical.htm

Diabetes mellitus is a disease which, on occasion, can result in a loss of consciousness or disorientation in time and space. Individuals who require insulin for control have conditions which can get out of control by the use of too much or too little insulin, or food intake not consistent with the insulin dosage. Incapacitation may occur from symptoms of hyperglycemic or hypoglycemic reactions (drowsiness, semiconsciousness, diabetic coma, or insulin shock).

The administration of insulin is within itself, a complicated process requiring insulin, syringe, needle, alcohol sponge and a sterile technique. Factors related to long-haul commercial motor vehicle operations such as fatigue, lack of sleep, poor diet, emotional conditions, stress, and concomitant illness, compound the diabetic problem. Because of these inherent dangers, the FMCSA has consistently held that a diabetic who uses insulin for control does not meet the minimum physical requirements of the FMCSRs.

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http://www.fmcsa.dot.gov/rules-regu...mcsrruletext.aspx?reg=391.43&keyword=diabetic


Diabetes. If insulin is necessary to control a diabetic driver's condition, the driver is not qualified to operate a commercial motor vehicle in interstate commerce. If mild diabetes is present and it is controlled by use of an oral hypoglycemic drug and/or diet and exercise, it should not be considered disqualifying. However, the driver must remain under adequate medical supervision. Upon completion of the examination, the medical examiner must date and sign the form, provide his/her full name, office address and telephone number. The completed medical examination form shall be retained on file at the office of the medical examiner.[/quote]

Edit to add links

Knew you would come up with the goods Bowell, thank you.

By the way I'm impressed with your figures on your diet, very interesting. Keep up the good work.

Regards
Angie

Thanks Bowell for all the articles - but again none of them even remotely state that 'the use of insulin' is an 'automatic fire' or loss of licenture anywhere. You asked 'would it make me think twice' -- the answer is 'no'. Because I know how to use insulin and it's possible to use insulin and never have a hypo. I keep great records and that wouldn't be a problem. Having quality of life is way more important and people don't have to fear these 'very remote 'scenarios' those guidelines are talking about - in US or Britain. They're talking about the extremely rare 'exception' to the rule and not the rule. PLENTY of people on insulin drive in both our countries. In my view it shouldn't be the 'least bit' of a concern. And even the very few hypos I've had would never have affected me from driving safely as I always carry glucose tabs with me everywhere I go - well when I was on metformin. Now that I've off Metformin my liver would always kick in if I took a little too much rapid acting.

The other rub is that it's a pretty unenforceable law. People could always fudge the records and would. Again - what matters is to get to the best control with the best potential for quality of life using 'your own choices' - but for the purpose of this 'mini discussion' I will say - that the 'laws on the books' that you cite would 'never' deter me one bit from taking insulin nor should they deter a newbie and that will be my input to them here.

But I DO thank you, very much, for the education!!

ladybird64 said:

Hi Grant

It's been a long day and the little grey cells are not functioning brilliantly so, in the simplest way possible, can you tell me what it is about my opening post you disagree with?

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No worries, Ladybird. I more 'agree with your comments' in your opening post than disagree. I just needed to point out that my comments in this portion of the thread were 'directly' related to this thread and not 'off topic'. That's all. I appreciate your perspective - you too, Bowell, and your cautions about overstatement, too, Pianoman. I can indeed tend toward 'hyperbole'. I'll try to rain it in, gang. Thanks for your patience.

It is not a rare exception to the rule, if you use insulin in the UK you currently CAN NOT drive lorries, buses and taxis!
I have just sent my renewal off for my taxi badge and in the medical requirements it states that insulin users CAN NOT hold a badge, not rare by a long way!
Angie

So you don't Drive for a living then.
Arrr So thats why your always on the bike ,, You cant drive ,,No shame in that mate.

I find myself agreeing with non of your statements No more then I disagree with them all :wink:


UK Law would also affect you as a tourist driving :wink:

Notifying health conditions
Information for Foreign Nationals Driving in the United Kingdom
You must inform the D.V.L.A. of any conditions that you suffer from before you came to the U.K. and which you may have already notified to the authorities. This must include any conditions you have recently become aware of. In most cases, the rules will be the same as those in other EC/EEA countries although there may be some differences. Higher visual standards apply for vocational drivers in the U.K..

Insurance
If you drive a vehicle on a road in the U.K .you must be covered by third party insurance either in the form of a green card or by a U.K. company. If you use a vehicle on the road without insurance you risk being fined and having the vehicle seized.

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If you have not notified insurance or DVLA you are then be classed as uninsured

See
http://www.lbp.police.uk/information/dr ... /index.asp

http://www.inbrief.co.uk/motoring-law/diabetes-driving-laws.htm

Also
http://www.patient.co.uk/doctor/Fitness-to-Drive.htm

http://www.southstaffordshirepct.nhs.uk/services/diabetes/docs/DrivingWithDiabetes2.pdf

http://www.ncbi.nlm.nih.gov/pubmed/12060053

[youtube]ZSumZ4qBltA[/youtube]

UK Law would also affect you as a tourist driving

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You got me worried by that one Bowell. :roll:
I exchanged my UK licence for a French one after developing diabetes because it was no longer valid . (actually I hate driving so normally don't ) I just went through the interactive questionaire 'Can you Drive in Great Britain' on the direct gov website and I read my licence as being valid when I visit . (but that of course is the reason for the EU directive making conditions similar for insulin users in all EU countries)

Just one of the many benefits being part of united states of Europe :mrgreen:

Hi Grant

We are agreed then, that the brain does not need carbs to survive - the liver can, albeit energy expensive, convert dietary protein into glucose. Mind you, it would seem that the energy need for this process, in low carbers, comes from liver fat.

“Energy production is expensive for the liver,” Dr. Browning said. “It appears that for the people on a low-carbohydrate diet, in order to meet that expense, their livers have to burn excess fat.” http://www.utsouthwestern.edu/utsw/cda/ ... 13557.html

Peter

Interesting study, thanks Peter. So not only does this demonstrate that a low-carbohydrate approach spares Glycogen but it uses additional fat (the expense mentioned above) in order to make Glucose for the brain... sounds ideal if one is looking to lose excess fat mass while reducing fat specifically from the liver too... I wonder what bearing this has on the Pancreas; as in the 600 calorie Newcastle/Optifast diet (also a short duration intervention) that was shown to reduce fat in the Liver and Pancreas?

reidpj said:

Hi Grant

We are agreed then, that the brain does not need carbs to survive - the liver can, albeit energy expensive, convert dietary protein into glucose. Mind you, it would seem that the energy need for this process, in low carbers, comes from liver fat.

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Yes, exactly. The brain needs GLUCOSE to survive and any source OTHER than glucose derived from eaten carbs is 'expensive energy-wise' and 'inefficient' to the task. That's really the most important caveat. Just because something 'can' work - doesn't mean it's the 'best for the job'. That's a pretty universal principle. Asking the brain to rely on gluconeogenesis for all its glucose needs, is akin to using a bicycle to get to your job 30 miles away. Sure, it CAN be done - but is it efficient? I just think the 'most efficient' means to an end is always a better choice with body processes. The medical community agrees with my view on this. I'm sticking with them when it comes to my 'brain'. :wink:

“Energy production is expensive for the liver,” Dr. Browning said. “It appears that for the people on a low-carbohydrate diet, in order to meet that expense, their livers have to burn excess fat.” http://www.utsouthwestern.edu/utsw/cda/ ... 13557.html

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Yes - in the end - the question to ask is "just how expensive IS this or that process we're leaning on to preserving hemeostasis and increasing energy".

Always wanting to return to the original poster's concern -- basically put, the 'reason' the medical professionals tell us to not harshly restrict carbs is because it simply 'doesn't produce long term health' (in their educated conviction) - 'because' it makes body systems work in 'emergency mode'. It's great that we have an 'emergency system' in these marvelous human bodies of ours. I'm GLAD I have one that works and can work for a long time - like that 'mini spare tire' you get in your new cars. It CAN get you pretty far - but it won't last the life of the car. The jury's out for me (and many others) as to whether very lo carb/higher fat can stand the test of 30-40-50 years of use. We simply don't have enough data yet to know. I'm betting it can't. Others are betting it can. I respect that. Risk is too high for me, though.

NewdestinyX said:

Always wanting to return to the original poster's concern -- basically put, the 'reason' the medical professionals tell us to not harshly restrict carbs is because it simply 'doesn't produce long term health' (in their educated conviction) - 'because' it makes body systems work in 'emergency mode'. It's great that we have an 'emergency system' in these marvelous human bodies of ours. I'm GLAD I have one that works and can work for a long time - like that 'mini spare tire' you get in your new cars. It CAN get you pretty far - but it won't last the life of the car.

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How do you know that ketosis is a "emergency mode" and not "the default operating condition"?

The fact that all of us, before diagnosis (and sometimes after), were operating in a "red alert emergency damage limitation mode" in which are bodies were sweating, urinating and defacating glucose out of our systems, might suggest that our extreme insulin response (or lack of insulin response) to refined carbohydrates isn't exactly the default operating condition either.

NewdestinyX said:

The jury's out for me (and many others) as to whether very lo carb/higher fat can stand the test of 30-40-50 years of use. We simply don't have enough data yet to know. I'm betting it can't.

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I'm betting that not controlling my BG and/or controlling it by pumping myself full of drugs isn't going to do me much good in the long term either. I'm not prepared to wait 30, 40, or 50 years to find out.

Here is yet another highly educated and professional Medical Doctor (one of an increasing number) who promotes an LCHF dietary approach... evidently he (and his partner) are convinced by the existing evidence; to the extent that they just went through a very healthy pregnancy using an LCHF diet. http://www.dietdoctor.com/

Here he is presenting at the recent Ancestral Health Symposium... if you watch right to the Q&A session at the end you may note at least 2 other highly educated, professional and peer-respected Medical Doctors who also support this approach...

[youtube]FSeSTq-N4U4[/youtube]

As for the OP I did not read it as "medical professionals tell us to not harshly restrict carbs" so much as "medical professionals tell us to eat lots of carbs"... a significant difference I'd say.

ladybird64 said:

Let me explain what I don't get. ...
One was a leaflet from the British Heart Foundation about the heightened risks of heart problems if you suffer from Diabetes. Dietary advice? As you would expect, cut the fat off everything, eat low fat spreads etc and there it was.."make sure you fill up on plenty of starchy carbohydrate foods"..I dropped the book in disgust. ...

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NewdestinyX said:

...akin to using a bicycle to get to your job 30 miles away. Sure, it CAN be done - but is it efficient? ...

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OK maybe not exactly 30 miles but how about the 26 Miles and 385 yards of the London Marathon course at rush-hour... a car versus a runner? The runner was faster, cheaper and had no issues with traffic, parking, congestion charges, pollution etc... etc...

[youtube]i7mlfGWJH5g[/youtube]

[youtube]0SiYP5sDzJ0[/youtube]

I guess it depends on how you define "efficient"... and in all seriousness there are studies showing that ketones may be used more efficiently by cells than glucose.

And for yet more discussion of human "fuels", how about cancers being fuelled by increased glucose uptake..?
[youtube]WUlE1VHGA40[/youtube]

I always read your posts with interest pianoman and you often make a lot of sense but when I keep reading references to various blogs and other dubious sources you can make it all seem so obvious that the best way to control diabetes is via alow carb high fat diet but for balance I feel it is worth stating very clearly that 1000's of diabetics myself included control their diabetes extremely well using other methods which dont need to be proved to be safe.

Interesting that you mention cancers being fuelled by increased glucose uptake, have you read this study which it states that cancers can also feed off ketones!! Perhaps a ketogenic diet is not as safe as some low carbers would have us believe after all?

You can read the paper here http://www.ncbi.nlm.nih.gov/pmc/article ... 7_3506.pdf