Low HbA1c results & driving

God knows!!! I almost lost my licence from an incident!! 5 years on I am consistently told my my wonderful consultant to keep my levels 5-8 consistently and if in any doubts 6 to 9. My hba1c was low whilst driving incident took place and I will never go through that again.

ArtemisBow said:

I see some people have achieved HbA1c results of 5% or lower, which is obviously great from a diabetes point of view, but how do you drive? At the moment my fasting levels are around 5.1-5.6, and I wouldn't want to take it lower because then I couldn't drive to work. I just don't know how people are able to achieve such low results without having issues driving - how do you do it?

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My HbA1c is 5.5% currently and I have to make sure I push my BG to 5 before I drive. Because of this, I don't think it would be possible to take my HbA1c any lower and legally be able to drive.

Smidge

5 to drive!

I have never had an issue, if my levels are in 5s i don't give it a second thought unless i have IOB. With IOB then it depends on how much and what my reading was, how long the drive is, and the chances of me going low from over injecting (which is rare).

I typically wake up and my morning readings are 5-6.6mmol/l (sometimes higher, sometimes lower, but usually in this range) and i drive to work every day. I have learned that if i don't eat anything, my sugars won't raise or fall, for 4-6 hours.. Because of this, i have no worries about driving in the 5s.
If they are in the 4s i take a small amount of fast acting carbs that should only raise me up 1-2mmol/L which keeps me in a good range since my basal seems to keep me level.

Also, as far I know we (canada) have no law that says i have to have a test before driving, like running errands would be a nightmare if you are in and out of a car 10 trips in a day, testing before you drive to the next shop.

The spirit is more "do you feel ok to drive?' "is there any reason why you shouldn't be driving now?" If i can answer those with confidence then no worries here! A cop can't stop me without just cause, and if they did, there is no way of them knowing i am T1D.

its safer to carb up to above 5,because like everything else, **** happens while your driving esp over long distance. you could get stuck behind an accident and be out alot longer than you thought, or you could break down and be out hours longer than you planned.....always better to carb up and be safe then adjust with next meal

I low carb and find my blood sugar is much more stable now. Zero need to carb up in any way, shape or form and I just abide by the DVLA rules for driving and testing.

Ali

Diamattic said:

5 to drive!

I have never had an issue, if my levels are in 5s i don't give it a second thought unless i have IOB. With IOB then it depends on how much and what my reading was, how long the drive is, and the chances of me going low from over injecting (which is rare).

I typically wake up and my morning readings are 5-6.6mmol/l (sometimes higher, sometimes lower, but usually in this range) and i drive to work every day. I have learned that if i don't eat anything, my sugars won't raise or fall, for 4-6 hours.. Because of this, i have no worries about driving in the 5s.
If they are in the 4s i take a small amount of fast acting carbs that should only raise me up 1-2mmol/L which keeps me in a good range since my basal seems to keep me level.

Also, as far I know we (canada) have no law that says i have to have a test before driving, like running errands would be a nightmare if you are in and out of a car 10 trips in a day, testing before you drive to the next shop.

The spirit is more "do you feel ok to drive?' "is there any reason why you shouldn't be driving now?" If i can answer those with confidence then no worries here! A cop can't stop me without just cause, and if they did, there is no way of them knowing i am T1D.

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So in Canada you don't have to report T1 to the licencing authorities?

SpikeThacker said:

its safer to carb up to above 5,because like everything else, **** happens while your driving esp over long distance. you could get stuck behind an accident and be out alot longer than you thought, or you could break down and be out hours longer than you planned.....always better to carb up and be safe then adjust with next meal

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I keep Lucozade, dextrose tabs and jelly babies in my car at all times for **** happens events !

ArtemisBow said:

@Diamattic I too am happy to drive when in 5s but obviously getting an HbA1c lower than 5 means being below 5 for a fairly significant amount of each day, which was what prompted the question.

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I've never had a problem in the mornings but just recently have been around 4.5 to 4.7 when testing around 17:00 for the homeward journey. I get a coffee and as we all know, you MUST have a biscuit to dunk in it so I'm over 5 within 1/2 an hour.

OK, so the problem in the UK is that although you are allowed to begin a journey with BG at 5mmol, you have to take on carb by law if your BG is under this - now, if my BG is 4.9 for example and I take on even 1 jelly baby, it's going to be about 7.5 mmol within 10 minutes even though I can guarantee that with no bolus available and 20 hours since my last basal, the only place my BG is going on my drive home from work is up - the law does not allow for your knowledge, judgement etc - it basically says I have to destroy my health to be allowed to drive. It further says that if your BG is under 4.5 mmol (or that might be 4, can't quite remember), you must eat something and wait until it is above 5mmol before driving. If you treat a hypo, you must not drive for 45 minutes after your BG has come back above 5mmol. You must test within 2 hours before the start of your journey and every two hours during your journey - the above rules apply throughout your journey.

It's all absolute rubbish, but it is the law. If you have an accident, regardless of whether it is your fault, the police can and will take your BG tester. if you have not tested before starting your journey, or if your BG wasn't within limits, you can be prosecuted and you will lose your license. Your license states that you are insulin-dependent, so the police do not have to know you are diabetic - they just have to run a driver check which is standard practice at an accident - and they will ask for your meter and check.

Given all of that, I really don't see how anyone who drives even twice a day to and from work can get an HbA1c below 5.4 or 5.5 and legally drive.

Smidge

urbanracer said:

So in Canada you don't have to report T1 to the licencing authorities?

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The reporting system is such that it is the responsibility of the doctor to report diabetics who they consider are unfit to drive. They only way you get reported is by having frequent hypos. This may not be the best system as diabetics without a regular doctor have no one who can report them, or if they do not tell their doctor about their problems they wouldn't get reported.

Last year they did add a section on to the drivers license renewal application that asks if you suffer or have ever suffered from: (and they give a long list of conditions, such as heart disease, strokes, epilepsy, narcolepsy, diabetes, and a bunch of other things). So until i renew my license in like 3 years, i have no responsibility to report anything.

I have asked about what happens when i check YES on that box, and have been told they give me a follow up form that asks if i have chronic 'insulin reactions' and if i check NO, and sign it, that is the end of that. I assume that they add it to your profile if you license is ever scanned while you are pulled over by police but they can't really do anything with info unless they have probably cause to ask (such as swerving, or dangerous driving.. it would have to be handled like if they thought you were drunk)

But Canada has no actual LAW that says i need to have a certain blood sugar level while driving, all we have is recommendations. I would assume if they pulled me over and brought a medical team to draw my blood and it was below 5, and i was actually driving dangerously they could charge me with reckless driving.

But they cannot pull me over and make me check my blood sugar, or ask to see previous checks. If i was in an accident they can request a medical team draw my blood but cannot ask me to check my sugars.