Professional drivers: 5 to Drive

[DEM1988]

Hi,

Do any professional drivers know about the '5 to Drive rule'?

My Endocrinologist told me about this rule as I have Reactive Hypoglycaemia and it was something I had to agree with to get my licence back.

Do you know if you have to be consistently above 5 mmol to drive?

Despite following a diet and using the medication Acarbose, I always seem to fall back into the 4 mmol range within about an hour of driving (using a Libre 2 sensor to track my condition).

Is this drop into the 4 mmol range okay?

 

[MrsA2]

@searley is this your area? I could well have the wrong person

 

[Deleted member 596235]

For any Aussies here, these are the Medical standards for licensing.

It is a general requirement that conditional licences for commercial vehicle drivers are issued by the driver licensing authority based on advice from an appropriate medical specialist (endocrinologist or consultant physician specialising in diabetes) and that these drivers are reviewed periodically by the specialist to determine their ongoing fitness to drive. For commercial drivers receiving insulin treatment, at least three months of blood glucose monitoring records should be reviewed in assessing fitness to drive.

 

[Rachox]

@MrsA , @searley hasn’t logged in this week, I wonder if @Nicola M can help?

Edit for typo.

 

[Nicola M]

@DEM1988 Hi there, This is taken from https://www.diabetes.co.uk/driving-with-diabetes.html#google_vignette and is the advice my diabetes team always gave me before I started driving

• Do not drive if your blood glucose is less than 4 mmol/l – or your blood sugar has been under 4 mmol/l within the last 45 minutes
• Keep your blood glucose above 5 mmol/l when driving
• Test your blood glucose levels within 2 hours of each journey
• Test your blood sugar every 2 hours whilst driving
• Keep a hypo treatment within reach for every drive

 

[DEM1988]

Thank you Nicola, this is exactly what I was looking for. It is what I expected - I'm going to be unable to go back to work driving buses/trucks as it's impossible for me to maintain glucose levels above 5 mmol whilst driving.

 

[searley]

@searley is this your area? I could well have the wrong person

Even for cars the rule is if ‘below 5 do not START to drive’

You are perfectly legal to drive down to 4, below 4 you are legally classed as hypo

So do not start a journey when below 5 without eating.

And stop driving if below 4

So YES going as low as 4 is ok, however due to the high risk of my hazchem loads I choose to stay higher when driving

It’s also a requirement to carry fast acting carbs.. I carry dextrose

and slower acting carbs.. I carry a box of cereal bars

 

[DEM1988]

Even for cars the rule is if ‘below 5 do not START to drive’

You are perfectly legal to drive down to 4, below 4 you are legally classed as hypo

So do not start a journey when below 5 without eating.

And stop driving if below 4

So YES going as low as 4 is ok, however due to the high risk of my hazchem loads I choose to stay higher when driving

It’s also a requirement to carry fast acting carbs.. I carry dextrose

and slower acting carbs.. I carry a box of cereal bars

Thank you for the response. This is actually very reassuring. Hopefully there might be a way for me to get back to driving professionally for a living.

 

[Tony337]

Hi
I read recently that a libre cgm is not admissable in a court of law and you should use a glucose monitor.
You cannot use your phone whilst driving even if you are checking your levels.

I read this so please don't take it as gospel as i don't want to depress anyone!

The law is daft at best as you can have a reading of 21.4 and be fit to drive but a danger at 4.8.
There has to be a bench mark and i get that.

As i'm in my 50th year of diabetes and i've been driving for 40 of those years i recently changed jobs so i can walk to work because i'm trying to run my levels as close to 5 as possible and driving was always going to be problematic.

I also consider myself to be the luckiest driver in the world as i've managed to avoid an accident which when you consider the amount of poor drivers there are but that might be an age thing!!!

Good luck

Tony

 

[searley]

Thank you for the response. This is actually very reassuring. Hopefully there might be a way for me to get back to driving professionally for a living.

First thing todo is stick to the rules for bg testing — has to be blood tests not cgm

Min 2 tests a day even days not driving, A test prior to first journey then through the day you must always have had a test within the last 2 hours whilst driving

You must carry fast action carbs, and slower acting like cereal bars

YOU MUST NOT miss a single test in the 60 days leading upto your DVLA appointed consultant appointment (yearly) as the consultant will go through the meter and check

You MUST keep a record of lows (3.9 or below) including reason/ treatment how you felt.. if whilst driving notes on action taken like (pulled into lay-by)

Adhere to rules like don’t drive for 45mins after a hypo

All this is evidence that it is safe for you to drive

During your consultant appointment you will be asked about the above, you will also be asked about hypo awareness and you MUST claim to be hypo aware and be able to describe some of the symptoms you may feel

You MUST NOT have any severe hypos during awake hours(that require help of other), self treated hypos are allowed but should be recorded as described above

You will be asked about the rules ie.. don’t start to drive below 5 etc…


For me I would be very careful about taking blood tests to minimise low bg’s…. You have a cgm so don’t test on your (every day) meter if you know you’ll be hypo - I have a 2nd meter that I use and don’t ‘disclose’ for the purpose of confirming hypos

CGM’s are totally irrelevant in relation to vocational licenses so those proper blood tests are crucial

 

[Antje77]

You cannot use your phone whilst driving even if you are checking your levels.

Slight correction here. You can use a phone but you can't touch it. People use phones for navigation all the time, which is perfectly legal.
I use google maps while driving, which keeps my screen open. I use a split screen so I can see my BG and my navigation without ever touching my phone.

 

[searley]

Slight correction here. You can use a phone but you can't touch it. People use phones for navigation all the time, which is perfectly legal.
I use google maps while driving, which keeps my screen open. I use a split screen so I can see my BG and my navigation without ever touching my phone.

Another correction here.. you can not use a handheld phone.. a phone in a cradle can be used… however this is a sort of moot subject as cgm is not acceptable for professional driving anyway

Companies(like mine) may go above the legal here and ban any touching of a phone, which is why my cgm readings are on my watch - again whilst good for a quick view you still legally need the actual blood tests too

 

[searley]

Another correction here.. you can not use a handheld phone.. a phone in a cradle can be used… however this is a sort of moot subject as cgm is not acceptable for professional driving anyway

Companies(like mine) may go above the legal here and ban any touching of a phone, which is why my cgm readings are on my watch - again whilst good for a quick view you still legally need the actual blood tests too

Relevant law attached which states you can not ‘hold and use’. of course this is UK law other countries may vary

 

[Antje77]

Another correction here.. you can not use a handheld phone.. a phone in a cradle can be used… however this is a sort of moot subject as cgm is not acceptable for professional driving anyway

Companies(like mine) may go above the legal here and ban any touching of a phone, which is why my cgm readings are on my watch - again whilst good for a quick view you still legally need the actual blood tests too

That's why I said no touching a phone, no need to touch it if it's in a phone holder.
And while CGM readings may not be accepted as official readings for professional driving, I'm very happy if T1 lorry drivers sharing the road with my vulnerable little car keep an eye on their numbers in between fingerprick tests so they're aware of drops and rises way before they become problematic.

Your screenshot says it's illegal to hold and use any device that can send or receive data, not that it's illegal to use it. If this was the case, your CGM would be illegal even if you didn't look at it, especially if it's coupled with a pump. I suppose you are allowed using satnav, as long as you don't fiddle with the device while driving.

 

[searley]

That's why I said no touching a phone, no need to touch it if it's in a phone holder.
And while CGM readings may not be accepted as official readings for professional driving, I'm very happy if T1 lorry drivers sharing the road with my vulnerable little car keep an eye on their numbers in between fingerprick tests so they're aware of drops and rises way before they become problematic.

Your screenshot says it's illegal to hold and use any device that can send or receive data, not that it's illegal to use it. If this was the case, your CGM would be illegal even if you didn't look at it, especially if it's coupled with a pump. I suppose you are allowed using satnav, as long as you don't fiddle with the device while driving.

You said you can’t touch it…. You can if it’s not hand held.. ie in a cradle

 

[Antje77]

You said you can’t touch it…. You can if it’s not hand held.. ie in a cradle

Really?
You are allowed to touch your phone while driving in the UK as long as you don't hold it in your hands?
My apologies for the confusion, I thought your laws were stricter than our Dutch ones!

 

[searley]

Really?
You are allowed to touch your phone while driving in the UK as long as you don't hold it in your hands?
My apologies for the confusion, I thought your laws were stricter than our Dutch ones!

Yes that’s why I empathised the ‘hold and use’ once in a cradle/mount it’s no longer handheld

Now there are caveats…. If operating the device leads to an accident then there are penalties

And again there are legal issues with mounts ie most people use windscreen mounts and many of those are illegal as they block view

But touching a phone, whilst stored in a cradle is allowed…. As is operating it by voice control or any other means ie remote control so long as the phone is not hand held

Also for those professional drivers where the company says no touching at all, there are plenty of ways to get cgm data on lock screens, via voice control or on a wrist watch

 

[IanA123]

First thing todo is stick to the rules for bg testing — has to be blood tests not cgm

Min 2 tests a day even days not driving, A test prior to first journey then through the day you must always have had a test within the last 2 hours whilst driving

You must carry fast action carbs, and slower acting like cereal bars

YOU MUST NOT miss a single test in the 60 days leading upto your DVLA appointed consultant appointment (yearly) as the consultant will go through the meter and check

You MUST keep a record of lows (3.9 or below) including reason/ treatment how you felt.. if whilst driving notes on action taken like (pulled into lay-by)

Adhere to rules like don’t drive for 45mins after a hypo

All this is evidence that it is safe for you to drive

During your consultant appointment you will be asked about the above, you will also be asked about hypo awareness and you MUST claim to be hypo aware and be able to describe some of the symptoms you may feel

You MUST NOT have any severe hypos during awake hours(that require help of other), self treated hypos are allowed but should be recorded as described above

You will be asked about the rules ie.. don’t start to drive below 5 etc…


For me I would be very careful about taking blood tests to minimise low bg’s…. You have a cgm so don’t test on your (every day) meter if you know you’ll be hypo - I have a 2nd meter that I use and don’t ‘disclose’ for the purpose of confirming hypos

CGM’s are totally irrelevant in relation to vocational licenses so those proper blood tests are crucial

Well you say awake hypos. I had a sleep hypos and GP informed the dvla of it upon renewal. I provided evidence from the ambulance report, GP was wrong and a nice letter from the DVLA basically called them out on it and pointed them to some learning material. Still took 3months to sort, but DVLA allowed me to drive.
Moved to a hospital clinic so GP has nothing to do with my diabetes care now.

 

[searley]

Well you say awake hypos. I had a sleep hypos and GP informed the dvla of it upon renewal. I provided evidence from the ambulance report, GP was wrong and a nice letter from the DVLA basically called them out on it and pointed them to some learning material. Still took 3months to sort, but DVLA allowed me to drive.
Moved to a hospital clinic so GP has nothing to do with my diabetes care now.

This is something where the goal posts tend to change at one point nocturnal 'severe nocturnal' hypos were acceptable now they are not... severe = requiring help of another to treat

Hypos where you treat yourself are acceptable.

The current rules for group 2 drivers is if you have a severe hypo you must immediately notify dvla and stop driving group 2

For safety (legally wise) if anything ever changes on relation to your health or its side effects it worth reading the current guidance, because Failure to comply with the law and the dvla finding out from a 3rd party (like a gp) could result is big fines and permanent removal of license

Goal posts are always changing like bg records had to be 3 months and that changed a couple of years ago to 6 weeks.. you as a professional driver are expected to keep yourself upto date with regulation changes - ignorance is not an excuse