Because the frequency and extent of these complications vary so greatly, everyone has the right to be assessed individually. Your day-to-day motor function, impacting your ability to safely operate a vehicle, can be impaired by health problems directly related to T1D that include:

 

• Episodes of hypoglycemia

• Diabetic eye disease (retinopathy)

• Nerve damage (neuropathy)

• Kidney disease (nephropathy)

• Cardiovascular disease (CVD)

• Peripheral vascular disease and stroke

 

Diabetes Canada supports people with Type 1 Diabetes who take insulin to control their blood glucose (sugar) levels can drive if they are regularly in touch with their medical team - a minimum of two clinic visits during the last year.

 

According to the 2015 Diabetes and Driving report from the Canadian Diabetes Association: 

• The fitness of people with diabetes to drive must be assessed on a case-by-case basis.

• Drivers with diabetes should take an active role in assessing their ability to drive by maintaining accurate blood glucose (sugar) monitoring with a well-calibrated blood glucose (sugar) meter.

• Drivers should take an active role in taking the necessary steps to maintain optimal diabetes control without the development of hypoglycemia unawareness.

• T1s should measure their BG (sugar) level immediately before and at least every 4 hours (more often if you do not recognize symptoms of hypoglycemia) during long drives.

• T1D drivers should always carry a BG (sugar) meter and low blood sugar supplies within easy reach.

• Persons should not drive when their blood glucose (sugar) level is <4.0 mmol/L. Driving should only commence when blood glucose (sugar) levels are in the 4.0 to 5.0 mmol/L range.

• Drivers should safely stop and treat themselves as soon as they feel symptoms of hypoglycemia (low BG) and/or impaired driving is suspected. It is strongly recommended to wait at least 45 to 60 minutes after effective treatment of a low blood sugar.

• Drivers with a history of severe hypoglycemia during the past year, hypoglycemia unawareness, recurrent previous hypoglycemic reactions, a recent marked reduction in HbA1c or HbA1c (average BG over 90 days) within the normal range should be informed that they are at high risk of experiencing severe hypoglycemia when driving. Efforts should be taken to minimize the risk, by measuring BG (sugar) levels before and periodically during each driving exposure.

 

When you apply for a driver’s license you must disclose any disease or disability that can impair the safe operation of a motor vehicle. In most provinces, your doctor is required to report anyone they consider unfit to drive. This could include someone who is newly diagnosed and just beginning to use insulin, someone who is not recognizing the early symptoms of hypoglycemia (low blood sugar unawareness), someone who has just experienced a severe hypoglycemic reaction, or someone who is not managing diabetes responsibly. Your license can be suspended or you could risk losing your license altogether if you are involved in an accident because of a low blood sugar. A report from a diabetes specialist as well as records of regular, effective self-monitoring blood glucose readings for a specific period of time would be required to support any efforts to reinstate your driving privileges. 

 

Each province has its own rules regarding glucose (sugar) control and being able to drive. It's important to understand your role in keeping yourself and others safe on the road before you take the wheel.

CONTRIBUTING SOURCE: Diabetes Canada