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Can diabetes lead to inability to drive?


First European guideline on diabetes and road traffic published

In most cases, diabetes is relatively easy to control, and diabetics can therefore take part in road traffic almost without restriction. However, it is still unsuitable for driving in individual cases. The first guideline "Diabetes and Road Traffic" has now summarized which conditions apply to diabetes for road traffic.

The guidelines for diabetics in road traffic were developed on the initiative of the German Diabetes Association (DDG). The key message is that almost all diabetes patients can drive on the road. For the first time in Europe, the fitness for diabetes was assessed for the guideline on a scientifically sound basis, according to the DDG. It is only in a few cases that vehicles with diabetes should not be driven.

Almost unlimited participation in road traffic possible

According to the new guideline, diabetics can participate in road traffic almost without restriction, both in private cars and professionally as bus, truck or taxi drivers. Quite reassuring news for the over six million people with diabetes in Germany. So far, according to the DDG, "the opinion was frequently held that insulin-dependent patients could no longer work as bus drivers or truck drivers, or that a high long-term blood sugar level was a reason for refusing a license."

Unfit to drive rather rarely

According to the experts, this assessment is not correct. "According to all available studies, the frequency of accidents in people with diabetes is only slightly increased," reports Professor Dr. Reinhard Holl, epidemiologist at the University of Ulm and co-author of the guideline. A high HbA1c value in itself does not constitute a reason for a driving ban and neither does insulin therapy. However, it may be unsuitable for driving, for example, in the event of repeated severe hypoglycaemia or sleep apnea syndrome, according to the experts at a press conference of the DDG to present the new guideline.

Legal uncertainties to date

So far, according to the experts, there were "no recognized medical-scientific principles for assessing the fitness to drive in diabetes." This also meant that there was a considerable gray area under liability law for doctors and treatment staff, emphasizes lawyer Oliver Ebert, also co-author of the guideline and chair of the Social Committee the DDG. In Germany, it is estimated that one in ten license holders is affected by diabetes.

Medical driving bans can be issued

According to the DDG, the guideline creates additional legal security for doctors and patients. It informs practitioners of the technically required procedure, including patient information. From now on, "a doctor who adheres to these scientifically proven recommendations should never fear liability," says lawyer Ebert. The guideline also offers the option of pronouncing a so-called "medical driving ban" if necessary and of specifying behavior when this is advisable.

Repeated hypoglycaemia is a reason for driving bans

The guideline offers diabetics the advantage that they can more easily take action against a faulty report and avert an impending loss of their license. According to Professor Dr. med. Baptist Gallwitz, media spokesman for the DDG, "against discrimination and exclusion, enables social participation and ensures professional livelihoods." According to the DDG, possible reasons for a loss of driving aptitude are "untreated sleep apnea or repeated severe hypoglycaemia. "If you have two severe hypoglycaemia during a year, you are not allowed to drive a car at first," reports Prof. Holl.

Improved road safety

According to the experts, there is a temporary unsuitability for driving in the event of "severe metabolic disorders, in the adjustment phase for insulin, but also in other important therapy changes or dose changes." The unsuitability for driving applies until the blood sugar metabolism is stable again. In the end, assessors will also benefit from the new guideline, since it gives them clear criteria that can be used to decide whether diabetes is fit to drive, explains Prof. Gallwitz. "The new guideline should help to improve overall road traffic safety," concluded the DDG media spokesman.

Practical tips for diabetics

The guideline also shows options that can be used to reduce the risk of hypoglycaemia in order to regain fitness to drive if necessary. Here, for example, medication changes, perception training or continuous glucose measurements with an acoustic warning function are mentioned. Practical tips for increasing road safety for diabetics are also given. For example, "Every insulin patient should measure blood sugar before starting a journey and have fast-acting carbohydrates, such as glucose, in their car," explains Professor Holl. (fp)

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