Riding a Motorbike

kitedoc

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Further to this, I looked up the Australian documentation relating to diabetes and driving. It's pretty much the same as the DVLA, they're concerned with hypos.

There is a very short section on "Acute hyperglycaemia"

https://austroads.com.au/publicatio...nt-and-management7r5-mgn/acute-hyperglycaemia

but that tells us the highs the OP is talking about aren't a worry.
But when bsl excursions are quoted at something like 10 mmol/l difference that may tell a difference story. Neither of us can say professionally that they are not a worry. And we can only guess at the competence of the assessor.
 
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@Timostags you mention you have not eaten for 14 hours when you test. I wonder if this could be the problem as much as the biking and adrenaline. Fasting can cause our livers to dump a load of glucose.
Perhaps, you can extend the lab rate experiment @Knikki suggested by eating.
 
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LooperCat

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Thinking about all this, I wonder if it’s a fasting plus adrenaline response - as @Knikki suggests, something to eat before going for a ride would seem like a worthwhile experiment. I feel pretty groggy at high levels, but that’s because I’m not used to them any more - back in the days when I wasn’t taking very good care of my diabetes, I’d be running constantly high and felt fine on it.
 

kitedoc

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Thinking about all this, I wonder if it’s a fasting plus adrenaline response - as @Knikki suggests, something to eat before going for a ride would seem like a worthwhile experiment. I feel pretty groggy at high levels, but that’s because I’m not used to them any more - back in the days when I wasn’t taking very good care of my diabetes, I’d be running constantly high and felt fine on it.
But if bsls fluctuated what were your measured visual acuities like ?
One HCP passed the OP but my post and concerns still stand as a general statement.
 

kitedoc

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If I had to look up what an "acuity" is when my BG was 5.3 ... :)
Yes, compared to at say, 20 mmol/l, for argument's sake ! The doctor would be testing the visual acuities to see what difference there might be and whether one or other fell outside the acceptable range for driving.
Perhaps scarier is during a hypo when one's peripheral vision seems to crowd in to a great degree.
 

Scott-C

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I'm guessing it's a result of the adrenaline rush?

It might be a mixture of things. Your bg was stable overnight, so basal seems ok, but maybe "foot on floor" rise kicked in pretty soon after you got up - my bg can easily go from 5 to 10 within an hour without 2u to pin it - then the effort of steering and tensing up muscles going round corners is kinda anaerobic "weightlifting" exercise and that's well known to generally raise bg, rather than lower like aerobic, then add in the adrenalin rush on top.

I can totally understand the reluctance to bolus before a ride, especially without food, but maybe worthwhile considering a smidgin, 1 or 2u to tail things off a bit?

Even a very small amount can be surprisingly effective while still in range, far less so once out of range.

Libre/cgm might help assess when the rise is happening - for example, foot on floor is always pretty noticeable on my traces if I don't pin it first thing, or it might become apparent that it's not that, but later through the anaerobic stuff.
 

evilclive

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Yes, compared to at say, 20 mmol/l, for argument's sake ! The doctor would be testing the visual acuities to see what difference there might be and whether one or other fell outside the acceptable range for driving.

Would any doctor do an eyetest at different BSLs for a licence renewal? That's going to be quite tricky to arrange isn't it?

Perhaps scarier is during a hypo when one's peripheral vision seems to crowd in to a great degree.

I don't think anybody disagrees that hypo is a no-no for operating machinery.
 

ert

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Everyone is different, but I have never found adrenaline impacting blood sugars. I know a number of diabetic Skydivers and they haven’t had a problem either. After you have thrown yourself out of a plane often enough there is no adrenaline rush, but there certainly is if you are preparing to go for a reserve ride. I have been there and done that a few times again no impact on blood sugars.
You're right we're all different. Some of us have enough insulin or have low enough resistance to clear sudden blood sugar spurts after extreme stress, an activity or event which causes your epinephrine (adrenaline) to flow, indicated by a rapid heart rate and tremors. Unfortunately, I'm not one of those people, being low insulin myself. Just this night, at 1.30 am my spaniel woke me up with a start, barking at the window for which my cgm showed a two-point spike in sugar which I didn't manage to clear. On top of this I had a further rise - the dawn phenomenon, at 5.30 am.
 
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Timostags

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What have I started lol

I have been to another day of DAFNE today, but had a good chat after with the DN and nutritionalist and got some good advice...

We agreed you can clearly see from Libre a spike in BG when I go for some fun on the bike. But that's fine, it's a few hours a week at most and as long as I treat the high afterwards there's no issue with that.
We also discussed that I get dawn phenomenon which is why I feel like I am constantly battling to bring down my BG. Every evening my BG is perfect, it just takes me all day to get it back under control. There's a few days where I wake up at the start of the dawn phenomenon and take a Correction at that point, and then my BG is perfect throughout the whole day.

So they have suggested a pump would be a really good option and will book an appointment with a consultant to look into this. I have never considered a pump before now and I'm sure there is already a hundred threads on the forum about them, could anyone send me a link so I can research them myself a bit?
 
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Bluey1

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[QUOTE="kitedoc, post: 2058218, member: 468714"
My specialist ( in Australia) has stated to me that he does not pass those TIDs who have poorly controlled BSLs.
There is more to assessment of fitness to drive than just simplistic guidelines and if doctors are slack in their assessment
they are at risk of being sued as well as appearing before a medical board, GMC etc.

And being assessed properly as being fit to drive safely when prescribed insulin is a privilege not to be abused.[/QUOTE]
Agree. My specialist is the same and last year like many other years I had to have a HbA1c below 9%.
 

kitedoc

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Would any doctor do an eyetest at different BSLs for a licence renewal? That's going to be quite tricky to arrange isn't it?



I don't think anybody disagrees that hypo is a no-no for operating machinery.
Thank you for your comment @evilclive .
Point one: the post was answering about measuring visual acuity formally under normal and high bsl conditions. Not put forward for practicality reasons, which i agree are pertinent. But it has been known to happen in Oz.
The mention about vision being affected by hypos was more an illustration on a personal observation, to show that hypos can do more than affect co-ordination and judgement and to indirectly show that things like measurement of visual acuity and peripheral vision also form part of a driver' medical.
 
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evilclive

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Thank you for your comment @evilclive .
Point one: the post was answering about measuring visual acuity formally under normal and high bsl conditions. Not put forward for practicality reasons, which i agree are pertinent. But it has been known to happen in Oz.

Interesting. To renew my licence, even after losing it for hypos (while asleep...), the only bit related to visual acuity was as mentioned in the form which can be found here :

https://assets.publishing.service.g...ta/file/778827/diab-medical-questionnaire.pdf

It's basically "Can you see? Do you need glasses?", and a tick box - no formal assessment required, and certainly no mention of hypers.

We can't be doing too badly though - roads about 1.5x safer than Australia :)
 
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kitedoc

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Interesting. To renew my licence, even after losing it for hypos (while asleep...), the only bit related to visual acuity was as mentioned in the form which can be found here :

https://assets.publishing.service.g...ta/file/778827/diab-medical-questionnaire.pdf

It's basically "Can you see? Do you need glasses?", and a tick box - no formal assessment required, and certainly no mention of hypers.

We can't be doing too badly though - roads about 1.5x safer than Australia :)
We have a visual acuity test and a peripheral vision test.
I do not think one can extrapolate safety figures from the stringency or otherwise of medical test assessments.
My view is: would you wish to have someone untested for their eyesight (where eyesight problems are more likely than the general population) or for their ability to see out of the corner of their eyes (peripheral vision or fields as it is called) allowed to drive unrestricted ?
I think the answer is obvious. I would always vote for the more strict testing for my sake and everyone else on the road or near it.
Any visual issue for me during a driver's license assessment has to be referred to an ophthalmologist for further assessment and certification.
And it is sadly not unknown for people with eyesight/field problems whether from diabetes or not to try to bluff or threaten the examining doctor into letting them pass.
I have already discussed the issue for high BSLs above and note @Chowie's post.
 
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One HCP passed the OP but my post and concerns still stand as a general statement.
And no-one can assume the competence of the assessor.

Not many things are 100%, so we hope that professionals are doing the correct tests and procedures with safe guarding the patient and other's.. The OP was passed and I hope he continues to enjoy motorbiking with the freedom it entails ( not for me though, too :nailbiting: I'm a bit of a wuss:shy: :rolleyes:)
 
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Timostags

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We have a visual acuity test and a peripheral vision test.
I do not think one can extrapolate safety figures from the stringency or otherwise of medical test assessments.
My view is: would you wish to have someone untested for their eyesight (where eyesight problems are more likely than the general population) or for their ability to see out of the corner of their eyes (peripheral vision or fields as it is called) allowed to drive unrestricted ?
I think the answer is obvious. I would always vote for the more strict testing for my sake and everyone else on the road or near it.
Any visual issue for me during a driver's license assessment has to be referred to an ophthalmologist for further assessment and certification.
And it is sadly not unknown for people with eyesight/field problems whether from diabetes or not to try to bluff or threaten the examining doctor into letting them pass.
I have already discussed the issue for high BSLs above and note @Chowie's post.
Interesting.
The DVLA in UK definitely seems alot more lenient/ignorant. We have laws that apply to low BG (DVLA classes <5.0 as unfit to drive) but nothing about high BG and very little covering eye sight. When applying to have to confirm if you wear glasses/contacts, and that you can read a number plate from 20 metres away with glasses. I think I remember a requirement to see an optition every so many months (not checked, unless involved in an accident I guess) and the only eye test I remember is when doing your test they check you can read the number plate.

I don't feel like short term highs have an affect on my sight, concentration or ability to drive (I know everyone is different and the DVLA should protect against the worst case). I am very aware of the dangers to me and others on a motorcycle I have lost 2 friends already from riding and have broken bones myself. If I didn't feel safe and in control I would NOT be on the bike.

I would be interested in a study on how high BG effects people's ability to drive if that showed a reduced ability I would give up the bike.

Oh and as a biker who hears "sorry mate I didn't see you" everyday as people endanger my life I definitely think the DVLA should be doing more about drivers vision