Key Elements to Drive Safely With Type 1 Diabetes

All drivers with type 1 diabetes (T1D)–whether they own a driver’s license or are in the process of obtaining one–should know that they need to take extra precautions and know the rules. 

Drinking and driving is dangerous, and so is going low and driving! Hypoglycemia—the drop in blood sugar levels that can occur in people with T1D—can lead to symptoms similar to those of drunkenness (e.g. confusion, blurred vision), putting the driver’s and others’ lives at risk. Certain diabetes-related complications (e.g., eye damage) can also increase the risk of an accident. 

That’s why there are specific legal requirements in Canada and precautions to take to ensure people with T1D drive safely.

Driving licenses and legal requirements in Canada 

If you live with T1D, you must complete certain procedures and meet requirements to obtain or maintain your driver’s license. While each province and territory in Canada has its own rules, here’s a general overview of common legal requirements:

• Type 1 diabetes statement: This statement is mandatory, and it must be submitted when you first apply for a driver’s license, when you renew your license, or when you’re diagnosed with diabetes. Depending on the province, the deadline for submitting this statement varies from “as soon as possible” to “within 30 days of diagnosis”. Please note that a false or misleading statement may result in a fine, or even the suspension of your driver’s license.
• Medical report: A detailed medical report completed by your doctor may also be required, including details of your current state of health and other test results (e.g., eye test). If you’re applying for a license for the first time, see whether there are any forms you can have your doctor or an authorized person fill in advance, and bring these documents when you do your driving test to speed up the process.
• Regular medical check-ups: Drivers with T1D are often required to undergo regular medical check-ups to assess their ability to drive safely. Certain tests may also be required occasionally (e.g., HbA1c measurement).
• Blood sugar management: Conditions to be met include proper management of your blood sugars, a good understanding/knowledge of diabetes, and avoiding episodes of severe hypoglycemia (inability to self-treat). A driver’s license could be suspended following a hypoglycemic or severe hypoglycemic episode behind the wheel that results in an accident or a traffic offence or that poses a risk to road safety. Exact procedures may vary depending on the province or territory and class of license. 
• Possible restrictions: Depending on the province or territory, class of license, and individual medical assessment, specific restrictions may be imposed, such as time limits for driving or restrictions on carrying passengers. 

It’s important to note that these requirements may vary depending on the province or territory in which you live, as well as your license type. We therefore recommend that you look up accurate, up-to-date information on the legal obligations specific to your situation and location online.

Before you sit in the driver’s seat

In addition to legal obligations, it’s essential to take certain precautions to ensure you drive safely. Here are some important measures to consider:

• Carry an emergency kit. Always carry a kit containing a blood sugar meter and enough fast-absorbing sugar to treat at least two hypoglycemic episodes (e.g., glucose tablets, sugar cubes, sugary drink) in case you experience a sudden drop in your blood sugar while driving. Here’s a list of what this kit might include if you use insulin pens/syringes or an insulin pump.
• Monitor your blood sugar regularly. 
  • Before driving: Always check your blood sugar to make sure it’s within a safe range. If it’s too low or too high, wait until you reach a stable level before driving. This document will help you determine what to do depending on your blood sugar.
  • While driving: Caution! Remember to park your vehicle to measure your blood sugar, as it is against the law to do so while driving. Blood sugar should be checked at least every 4 hours, or more regularly (e.g. every hour) if you experience symptoms of hypoglycemia while driving, if you lost awareness of symptoms of hypoglycemia, or if you have already experienced severe hypoglycemia. Continuous glucose monitors (CGM) are helpful for monitoring blood sugar while driving. CGMs offer the option to program alarms to warn you if a risk of hypoglycemia occurs; when you drive, you can set them to a higher threshold so that you get a warning before hypoglycemia occurs. In the future, car entertainment systems may be compatible with CGMs to facilitate access to alerts.

• Be alert to symptoms: If you experience signs of hypoglycemia or hyperglycemia while driving, such as confusion, dizziness, blurred vision or excessive fatigue, or if an alarm notifies you that you have reached a threshold that could be unsafe, stop safely and treat your symptoms before you get back behind the wheel. If you use a CGM and find that your symptoms don’t match the blood sugar displayed, be sure to validate the result with a capillary blood sugar test. In some provinces and territories, it is recommended to wait at least 15 minutes after treating hypoglycemia before driving again.

Knowing the specific requirements in your province or territory and applying the appropriate preventive measures while driving will allow you to safely enjoy the freedom and independence that driving offers!

References:

• Module «Tout sur la conduite et le diabète de type 1», plateforme Support-T, à venir