Should a diabetic with tight sugar control drive?

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INVC,,

Delhi,,

Worldwide, diabetics are required to produce proof of good blood sugar control to keep their driving license. A study by Dr. Donald A. Redelmeier, professor of medicine at the University of Toronto has shown that diabetics, who keep their blood sugar tightly controlled run the risk of having traffic accidents due to low blood sugar, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

The risk is substantial, accounting for almost 50 percent of the accidents. The accidents are mostly related to severe hypoglycemia in association with strict blood sugar control. The findings are published in PLoS Medicine.

For the study, Redelmeier’s team collected data on 795 diabetic drivers. They found that one in 14 of the drivers had been involved in car accidents. Those with low blood sugar were more likely to have had an accident than were diabetics whose blood sugar was not as well controlled. Moreover, the risk for having a car accident increased
fourfold if the person had a history of hypoglycemia. Diabetics should not to drive if they feel dizzy or have other symptoms of hypoglycemia. If some one has had a hypoglycemic episode yesterday, he or she should not drive the car next day.

Patients with diabetes should drive only if diabetes is under control and there is no evidence of end organ disqualifying disease. Definitive criteria are not available but an American Diabetes Association table indicates upper limits for acceptable control as follows:

  • 1.    Fasting sugar: Normal 115 mg/dL, acceptable 140 mg/dL
  •     2 hour postprandial plasma glucose: normal 140 mg/dL, acceptable 200 mg/dL
  • Glycosylated hemoglobin A1C: normal 6 percent, acceptable 8 percent

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