What is diabetes? 

Diabetes is a common but serious metabolic condition characterised by hyperglycaemia (high blood glucose). It is a multi-system condition that affects multiple organs in the body and can be complex and unpredictable. People with diabetes are at risk of diabetes complications and comorbidities (coexisting medical conditions). 

Five million people in the UK have diabetes – approximately one in 12 working-age people. Around one million people with diabetes are currently undiagnosed (International Diabetes Federation Diabetes Atlas 10th Edition, 2021, P104). Type 1 diabetes is an auto-immune condition. However, 90-95% of people with diabetes have type 2, which is a largely preventable, environmental condition. Risk factors include diet, exercise/activity, stress, body mass, age, race and genetics. One in nine people has pre-diabetes.  

Effect on road safety 

Risks to driving and road safety occur when diabetes is not managed effectively. There are several risks: 

1. Severe hypoglycaemia (hypo): sudden incapacitation when blood glucose drops too low due to use of insulin and/or other treatments 

1. Moderate/mild hypo: impaired functioning such as reduced coordination and balance and impaired judgement 

1. Neuropathy: nerve damage in feet which reduces sensitivity to vehicle pedals and affects driving performance. Some medication to treat neuropathy increases drowsiness  

1. Visual impairment: impaired sight due to diabetes, including retinopathy, cataracts and glaucoma 

1. Hyperglycaemia: impaired functioning, such as coordination and balance and impaired judgment due to blood glucose being too high  

1. Co-morbidities: the risk of heart attacks, strokes, sleep apnoea and other conditions are increased among people with diabetes  

Potential indicators of diabetes 

The most common symptoms of diabetes include increased thirst, frequent urination, feeling tired and losing weight. However, one in six people with diabetes presented no symptoms at the time of diagnosis. If a person is struggling to manage their diabetes, they may present with frequent and moderate or severe hypos, or start to present with diabetes complications, including nerve damage and affected sight.  

Driving with diabetes 

The rules about driving with diabetes depend on the treatment type (e.g. using insulin) and the licence type (i.e. whether for cars and motorcycles or commercial vehicles). Some drivers with insulin are required to report their condition to the DVLA and may require an assessment in terms of medical fitness to drive. As diabetes is a progressive condition, drivers need to stay up to date with any changes to their condition that might require them to self-report to the DVLA.  

What employers can do 

• Educate your driver workforce about diabetes signs and symptoms and, where appropriate, share that they can get a diabetes test at their GP. 

• Ensure that drivers with diabetes are able to test and administer treatment before and during each journey – for some drivers, the DVLA requires testing no more than two hours before driving and every two hours throughout. Shift patterns and driving targets should enable compliance with these requirements and enable drivers to take regular breaks and, where necessary, eat at specific times.  

Resources 

Further guidance for employers on safe driving practices, managing diabetes in the workforce and driving risks are available at www.diabetessafety.org.  

Driving regulations for people with diabetes 

Information for people who have or suspect they may have diabetes is available at www.diabetes.org.uk.