Proposed EU Legislation

[Bobba 2]

I see in today's Daily mail that the DVLA is proposing a change to the regulations as a result of an EU directive.
Their suggestion is that any diabetic having 2 hypos a year will lose their licence even if the hypos are at night.
This must be the most stupid proposal ever made.
It will mean that anyone using insulin will keep their dose low so that they never have a hypo with the consequence that their HB1c will be higher than necessary with all of the long term consequences.
Why are diabetics singled out for such draconian treatment, how many accidents have been caused in the last five years by diabetic comas? There must be data on this.
Diabetes UK must fight this proposal with all of the force it can muster in order that common sense will rule.

 

[hallii]

All this assumes that any sane diabetic would count how many hypos he/she has and then report them to the DVLA. Not many I think, anyway, who would diagnose a hypo? You might pass out due to low blood pressure or maybe a sudden viral infection.

It's just another bit of stupid EU rubbish.

H

 

[Hobs]

Has anyone got a link to this DM article? Google could not find anything

 

[Grazer]

Not got a link but it was in today's mail. The EU wording is just about people "prone" to hypos, but as usual good old UK is translating it to the nth degree!
Malc

 

[Bobba 2]

Hello,
The link to the Mail article is
http://www.dailymail.co.uk/health/article-2028152/Million-drivers-face-losing-licence-EU-diabetes-diktat.html

 

[phoenix]

This isn't necessarily as bad as the Mail is painting it. It is not having a hypo that is the problem, it is having more than one hypo that is severe enough to need someone elses help.
The rules in the UK have probably been stricter than the rest of the EU up until now. There has been the ludicrous situation where someone using insulin, from elsewhere in Europe ,could drive or even move to the UK and use a licence without any restrictions . I was able to swap my UK for a French one with no conditions when I developed T1.(though it would have been withdrawn and I would have had to go before a medical 'tribunal' in the event of an accident.
There was a long period of discussion in which the UK had a full input. The directive has been implemented in many other EU countries already.
These are the 2 proposals on hypos

RECURRENT SEVERE HYPOGLYCAEMIA
Definition3.2 Severe hypoglycaemia means that the assistance of another person is needed.
Recurrent hypoglycaemia is defined as a “second severe hypoglycaemia during a period of
12 months.” On occasion, severe hypoglycaemia can result from medication other than
insulin.
Current UK standard
3.3 Drivers who have had frequent hypoglycaemic episodes must cease driving.
Licences may be refused or revoked for such applicants if they are considered “a source of
danger to the public”. However, if control has been re-established, a licence can be issued
or renewed.
New EU Rules
3.4 Drivers experiencing recurrent severe hypoglycaemia shall not be issued a licence.
This is more clear cut than previous EU rules, particularly because of the clear definition of
recurrent hypoglycaemia as being two episodes in 12 months


IMPAIRED AWARENESS OF HYPOGLYCAEMIA
Definition
3.7 Impaired awareness of hypoglycaemia means an inability to detect the onset of
hypoglycaemia due to a total absence of warning symptoms.
Current UK standard
3.8 Drivers with impaired awareness are required to cease driving, until awareness has
been re-gained.
New EU Rules
3.9 Driving licences shall not be issued to, nor renewed for, applicants or drivers
who have impaired awareness of hypoglycaemia. In practice, this will prevent some
applicants and existing drivers from holding a licence.

Personally I don't think anyone with total hypo unawareness should be driving


On the plus side people on insulin will be able to apply for group 2 licences if:
• No severe hypoglycaemic events have
occurred 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.
http://www.dft.gov.uk/dvla/consultation ... tions.aspx

 

[iHs]

Personally I don't think anyone with total hypo unawareness should be driving

This is going to be very difficult to define. Just because some people have the odd hypo feeling during the day and test their bg levels to find that they are 2.?? on their bg meter doesn't mean that they have lost total hypo awareness. If they had lost their awareness completely, they would be unconcious on the floor and in no fit state to test anyway.

This current proposed move by the DVLA is going to make many insulin dependant diabetics very worried and will start to raise questions as to whether the bolus/basal regime has a future. You can bet your bottom dollar that there are more bolus/basal diabetics turning up in A&E than biphasic diabetics especially where hypoglycemia is concerned. Why is this so ?....... well it's lack of guidance over calculating insulin using a ratio and lack of sufficient teststrips being prescribed by GPs.

Thank goodness I've got a pump.

 

[Energize]

Presumably, this legislation will have implications on the PCTs, as GPs will be required to prescribe potentially MORE test strips to people with diabetes. Also, this will neccessarily include Type 2s who are taking glucose lowering medications.

Can I assume the arguement for test strips will be strengthened, then?

 

[phoenix]

This is going to be very difficult to define. Just because some people have the odd hypo feeling during the day and test their bg levels to find that they are 2.??

yes, I agree about that, I would suggest that someone who has tested to check whether they were hypo at 2.0 has some awareness, just at a lower level. They are not totally unaware, and must be compos mentis enough to check.
Of course the level considered to be hypo can differ from country to country, and probably doctor to doctor. My doc actually only ever comments on below 60 (3.3mmol).

 

[chainedhorse]

I live in a rural setting and with no bus service I need to use my car to get to work. As previously stated in other posts this is discrimination against us. What about our rights, why must we be penalised by faceless people in another country dictating what should happen. I have had Type 1 Diabetes for over 20 years and have served in the Armed Forces and never been treated like this. If I lose my licence because of this ruling I will have to use a bike to get back and to for work increasing the risk to me whilst on the road. What happens if I have a Hypo whilst riding my bike and fall in front of a car? I become another statisic and a driver has my injury/death on their mind. Good move Brussels!!!!

 

[ebony321]

It's useless to bring anything like that into place.

Same as people with epilepsy, i doubt 100% of people who have a seizure won't inform th DVLA as they will have to wait to be seizure-free for a year to be able to drive again.

some people simply can't live without a car, some people rely on cars to get to work to earn money to put a roof over kids heads and feed mouths.

People simply won't say anything in fear of risking of losing their licence.

It's ridiculous that it is NOT our fault we developed diabetes. yet people who CHOOSE to drink and drive get only a 6 month ban.

I'm pretty **** sure that drinking and driving causes more damage than driving/hypo's does.

I have more than 2 hypos, a few of which are in the night, i was concerned once that my hypo awareness was too low as i never felt it above 3.4, but mu doctor assured me it's normal for younger people to recognised at lower levels as the body is younger it can cope and work still with a lower glucose level.

All 3 of the doctors that were required to fill out my medical form for driving are perfectly aware of my 'hypo history' and all of them signed that form with no hesitation.

Utterly ridiculous.

 

[phoenix]

What about our rights, why must we be penalised by faceless people in another country dictating what should happen

here is the report of the working group that advised the EU .
http://ec.europa.eu/transport/road_safe ... l_1_en.pdf

The comitttee had 10 members and an external advisor. Representatives from the UK
Dr Delyth Sheppard, Dr Bridget Boyd, Prof Brian Frier (external advisor) I would suggest that the British had as much or even more influence in their advice than any other country!
A few extracts

The thresholds they use for hypos are clinical ones and lower than the '4 is the floor ' as often talked about on here

Hypoglycaemia is the most common side effect of insulin treatment. Asymptomatic plasma glucoses lower than 60mg/dl are frequent: as many of 10% of the BG readings of a patients attempting to obtain good glycaemic control will fall in this range. Mild symptomatic hypoglycaemia will happen on an average of 2 times a week, and will often be corrected by the patients themselves.
More problematic are the severe hypoglycaemia’s, where often somebody else (family, colleague at work, nurse or physician) have to intervene with treatment. This happens approximately to at least one third of patients one or more times a year. The risk of severe hypoglycaemia is skewed and a subgroup of patients experience most of the severe hypoglycaemic episodes per year

.

Some diabetics experience a loss of the warning (largely reduced sympathetic neural(adrenergic and cholinergic) actions) symptoms or an impaired perception of or reaction to the early warning symptoms of hypoglycaemia. The early warning symptoms such as anxiety, palpitations, hunger, sweating or tremor normally occur when the blood glucose is about 55-60mg (3.0mmol/l). The patients with unawareness do not realise that the plasma blood glucose level is decreasing below the threshold for neuroglucopenia (about 2.5mmol/l) and do not correct the blood glucose by food intake. This is called hypoglycaemia unawareness.

(it also mentions how to regain awareness by running higher glucose levels for

.
These are the numbers they suggested should not be able to drive

Three quarter of people experiencing severe hypoglycaemia during the last year, experienced only 1 such an event; one quarter (those with hypoglycaemic unawareness) have more than 1 event a year and were responsible for about 60% of all hypoglycaemic events. This small subgroup (about 3 % of the patients with T1DM or long standing T2DM) has a very high risk for recurrent severe unrecognised hypoglycaemia, and are therefore at risk if driving.

 

[sugar2]

Phoenix, as ever, thank you for your informative posts.

I was really scared about this, but the info that you have posted has reassured me somewhat, that little BG dips, that I am aware of, and can treat myself quickly and easily do not mean I am about to lose my license.

I hope that they add some exception for night time hypos though. I slept through a firealrm at uni.... not hypo, just a very heavy sleeper. I can see that severe hypos during the day may impair your ability to drive...but if the only reason a hypo becomes severe is because you are asleep this sees a little illogical?

 

[NorthernRose]

I had my licence revoked last year on account of a head injury. I was told '6 months', but despite filling in every form back in February, I'm still waiting. I spoke to my GP and consultant who both confirmed they had sent favourable reports to the DVLA. Then this happens!
Testing twice a day! Well DAFNE graduates have a reason to test pretty much every time they eat. I get through a lot of test strips - up to 7 or 8 a day.
All I can say is this. The NHS will save lots of cash on prescriptions since there is no point testing if the results could lose you your licence. Sure, you also risk hyperglycaemia - the blurred vision etc. But as has been said already - who the hell will want to admit recording a hypo?
If it is only those hypos requiring third party assistance, then stay home, never go out, don't have contact with anyone unless you're sure you can trust them.
It seems we are now presumed guilty, and must prove ourselves innocent if we are to work, play and lead 'normal' lives. I get the feeling someone will end up using the Human Rights Act on this one.
Free bus pass? Don't make me laugh. I'm in a rural area, and have an elderly mother with serious mobility problems. Since losing my licence she's barely left the house.
Cycles mean using energy so more prone to hypos, also out in all weathers, vulnerable and my mum is past sitting on the crossbar!
I have looked at pedicabs, but wonder if I should start looking around for 1bhp? (Pony & trap!)
Or maybe look at the possibility for emmigration? Are diabetics presumed guilty in Canada, Oz, the US?
One very annoyed (former) driver!

 

[deediamond]

wow your stories are heart wrenching. I have hypo thyroid/coeliac and now Reactive Hypoglycemia.

My hospital consultant wrote on my notes that I shouldnt drive until I get this under control but they dont seem to know much about this condition and have just left me, no support groups. I have to manage it with a sugar free gluten free diet.

I had to call DVLA to tell them on monday as if I get into a little car incident of any kind I wont be insured as it was on my records. I KNOW when im going hypo, I dont leave the house if im having a bad day . Im fully aware of going hypo and always check my bloods. If I eat the right foods and always carry the right foods with me outside then I am ok.

obesity, mobile phone users, drink/drug drivers, epilepsy im sure are all much riskier behind the wheel than I am (cant they take into consideration my perfect 25 years driving record? ) I feel my human rights are being taken away along with everything else Ive lost (husband/friends/work).

HOW CAN WE PROTEST THIS???
D
X

 

[copelandj]

I am 17, type 1 for 18 months and just had my licence revoked for a year following two severe night time hypos, in a period of two weeks, which occurred after very heavy training sessions the night before. I am so disappointed as I haven't had any problems at all before this. Definitely feel night time hypos should not be included in this legislation.