LTB 368/13 Driving with Diabetes

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LTB 368/13 Driving with Diabetes


No. 368/13
Ref V4/13
Date: 28 May 2013
To: All Branches
Dear Colleagues
Driving with Diabetes
The Health, Safety & Environment Department are issuing this advice following the recent announcement by Diabetes UK that their latest research has revealed that the number of people in the UK who have been diagnosed with diabetes has reached three million for the first time, equivalent to 4.6 per cent of the UK's population. The figure represents an increase of 132,000 people diagnosed with diabetes over the last year. A further 850,000 people in the UK are thought to have undiagnosed Type 2 diabetes.


Royal Mail and British Telecom have a combined fleet of around 75,000 vehicles and 150,000 Drivers, the majority CWU members. It is inevitable that a proportion of those drivers will have diabetes. Occupational Road Safety and compliance with motoring laws are essential to the safety and wellbeing of CWU members as is correct medical advice and early diagnosis of any medical condition that may affect wellbeing and driving safely. Diabetes UK is launching its biggest-ever public health awareness campaign on risk factors and symptoms of Type 2 diabetes which we are pleased to support. Please ensure members are aware of this information.


Having diabetes does not mean you cannot drive a car or a motorbike. Given that your diabetes is well controlled, and you doctor states that you are safe to drive, there is no reason why you cannot have or hang on to a driving licence. Nonetheless, you may need to let your insurance company and the Driving and Vehicle Licence Agency (DVLA) know that you have diabetes.


Who do I need to inform about my diabetes?
No matter how your diabetes is treated, you must by law inform your insurance company that you have diabetes.
· If your diabetes is treated with insulin, you must inform the DVLA. (Insulin - Inside the pancreas, beta cells make the hormone insulin.
With each meal, beta cells release insulin to help the body use or store the glucose it gets from food. Insulin is prescribed to people with type 1 diabetes. This is because type 1 diabetes destroys beta cells in the pancreas, meaning that the body can no longer produce insulin. People with type 2 diabetes make insulin, but their bodies don't respond well to it. Some people with type 2 diabetes may take pills or insulin shots to help their bodies use glucose for energy.) If you are applying for a driving licence for the first time, and your diabetes is treated with tablets or insulin, you also must inform the DVLA.
In addition:
· You must inform the DVLA if any diabetes complications develop that may affect your ability to drive safely. (Complications that can occur as a result of having diabetes and involve the disruption of a variety of bodily systems, mainly due to fluctuations in blood glucose levels, particularly elevated blood sugar over a long period of time. Controlling blood glucose levels and blood pressure has been proven to reduce the risk of diabetes complications. Diabetes affects the arteries and there is a risk of nerve disorder, kidney damage and eye diseases which have been found to be more common amongst those with poor control. By closely controlling blood sugar levels, blood pressure and cholesterol, people with diabetes can help lower their risk of diabetes complications. Spotting problems early and seeking medical advice in crucial. Moreover, a lifestyle involving a good diet, regular exercise and no smoking also help to reduce diabetes complication risks).
· If you fail to inform the DVLA or your insurance company then your driving insurance will be invalid.
· You do not need to tell the DVLA if you are treated by diet alone or by tablets that do not bring on hypoglycemia. However, if you change from tablets to insulin treatment, then they must be informed.
You do not need to tell the DVLA if you are treated by:
· Diet alone
· By tablets which carry no risk of hypoglycemia
· Non-insulin injectable medication such as Byetta or Victoza (unless you are also on tablets which do carry a risk of hypos)
· Tablets which are deemed to carry a risk of hypoglycemia are sulfonylureas and prandial glucose regulators.
· Unless you have other complications or reasons that may affect your ability to drive.

For information on the current DVLA guidelines, please visit the official DVLA and Direct.gov.uk websites.
· For more information about informing the DVLA, DVLA guidelines and the current medical rules for UK drivers, see DVLA paragraph below.
Why do I need to inform the DVLA that I have diabetes?
You must by law inform the DVLA that you have diabetes regardless of how you treat your diabetes. When applying for or renewing a driving licence, you must answer "YES" to the question if you have diabetes. If you have a driving licence and are diagnosed with diabetes you should, write a letter to the DVLA telling them about your diabetes and how it is treated. If you are treated with insulin, you will be sent another form (Diabetic 1) asking for more information. This includes the name and address of your General Practitioner or hospital doctor. The way your diabetes is treated may or may not affect the type of licence you have. The DVLA will want to check that you are fit to be driving and so they will contact your healthcare team to get an assessment of your suitability to drive.
· For more information about informing the DVLA and applying for a C1/C1+E licence please see attached Diabetes UK guide to 'Applying for a
Driving Licence if you have Diabetes'.


Driving safely
You should not drive if you;
· Have difficulty recognising the early signs of hypoglycemia. (A person with hypoglcemia may feel dizzy, fatigued and start sweating and can also go pale, feel weak, hungry, drowsy, confused, start trembling, have blurred vision and a rapid heartbeat. A person can lose consciousness and even lapse into a coma in extreme cases).
· Have problems with your eyesight, which are not corrected with glasses.
· Have numbness or weakness in your limbs.
· Have been drinking alcohol.

If you are unsure about any of these you can talk to your GP or hospital diabetes team for more advice.


What's more, diabetic complications may or may not affect you eligibility to drive, and is generally dependent on whether the symptoms themselves impair your driving ability.


Diabetes and Driving for Work
If you drive for work and are diagnosed with diabetes, you may be worried about whether you can continue working. A different set of factors apply depending on whether your diabetes is treated with insulin, tablets or diet alone and what class of vehicle you intend to drive. If you are diabetic and you work as a driver, whether you can continue will depend on a number of factors..
Taxis and Large Passenger Carrying Vehicles (PCVs - Buses & Coaches etc).
There is no blanket ban across the UK and having diabetes doesn't stop a person from driving a Taxi although it may prevent someone from driving large passenger carrying vehicles (PCVs). Local councils issue licences for taxis and minicabs. Their policies may vary throughout the UK and it is best to check with individual councils for further information. Taxi drivers dependent on insulin may find it harder than those on tablets.
Emergency Services - 'Blue Light' Vehicles
There is currently a blanket ban for diabetics driving emergency vehicles. Anyone with diabetes mellitus, treated by insulin, will not be entitled to drive emergency vehicles currently, such as ambulances and fire engines, however, charities such as Diabetes UK are campaigning to have this particular blanket ban lifted.


Diabetes and driving HGVs and PCVs
If your diabetes is treated with diet or diet and tablets, you may hold a licence to drive either a large good vehicle (LGV) or a passenger-carrying vehicle (PCV).

If your diabetes is treated with insulin, you will automatically lose the entitlement to drive vehicles within:
· the C1/C1+E class (including categories C1, C1E, D1, D1E, C, CE, D or DE)
This includes vehicles between 3.5 and 7.5 tonnes with a trailer, up to a combined weight of 8.25 tonnes.


However, a driver may apply to be assessed individually for fitness to drive these vehicles but must meet a number of conditions:
· No episode of hypoglycemia at the wheel within the last 12 months
· Will need to assessed at least once a year by a diabetes consultant
· Regularly testing your blood glucose levels, particularly before and around times of driving
· Have stable insulin for at least a month
· Have no other conditions that would invalidate an application for the license
· Sign a declaration to follow doctor's decisions and report any significant change in your condition to the DVLA
The process towards getting your vocational entitlement to drive involves a three step process:
· Initial application forms
· A medical questionnaire
· A further medical questionnaire and an examination by your consultant


Driving Insurance
Whilst you must inform your insurance company about your diabetes, this should only affect your car insurance premiums if you are put onto
a restricted licence. Car insurance companies are not allowed to discriminate against people with diabetes. If you are on a restricted licence,
you may see your insurance premiums rise, however, a suitable amount of shopping around for a good quote can help to make up for this.
· Further Information on Diabetes and car insurance is available at: http://www.diabetes.co.uk/diabetes-and- ... rance.html" onclick="window.open(this.href);return false;
DVLA (Driver and Vehicle Licensing Agency)

Diabetes driving information is subject to change as the DVLA adapts its Medical Rules for Drivers. For up to date information direct from the DVLA, this can be obtained by visiting the DVLA Website or calling their enquiry lines. details are:-
DVLA Website: http://www.dft.gov.uk/dvla/" onclick="window.open(this.href);return false;
DVLA Tel No: 0870 240 0009
DVLA Medical Enquiries Tel No: 0870 600 0301
Contact Details:-
Diabetes UK
Macleod House,
10 Parkway, London NW1 7AA
Tel 020 7424 1000
Fax 020 7424 1001
Email: info@diabetes.org.uk
Website: http://www.diabetes.org.uk/About_us/Contact_us/" onclick="window.open(this.href);return false;
Diabetes UK and is the leading UK diabetes charity and the largest organisation in the UK that works for diabetics by campaigning, funding research and helping diabetics in a variety of ways. Diabetes UK spends millions each year to improve treatment outcomes for UK diabetics. Diabetes UK also lobbies the government for better standards of care. Diabetes.co.uk fully supports the efforts of Diabetes UK.
Diabetes.co.uk
Diabetes.co.uk is a privately owned community website focusing on providing a wealth of diabetes information, with a primary goal is to reduce suffering in the diabetes community, offering a range of unique resources to their Website visitors. They are contactable via the excellent Website at: http://www.diabetes.co.uk/index.html" onclick="window.open(this.href);return false;
This LTB and Guidance has been compiled in conjunction with Diabetes.co.UK and Diabetes UK to whom we are most grateful. The contents are not a substitute for seeking medical advice from an individual's G.P. or Hospital Consultant.
Yours sincerely



Dave Joyce
National Health, Safety & Environment Officer
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(Attach as separate pdf)
Diabetes.co.uk Guide
Applying for a Driving Licence and Informing the DVLA if You Have Diabetes
If you have diabetes and drive, then you must be sure that the Driving and Vehicle Licence Agency (DVLA) as well as your insurance company are aware of this.
This section details the forms you will have to complete when applying for a driving licence and the conditions you must meet in order to receive a driving licence, as well as how you should inform the DVLA if you have diabetes and already have a driving licence.
Informing the DVLA
You must by law inform the DVLA that you have diabetes regardless of how you treat your diabetes.
If you are applying for licence, answer "YES" to the question if you have diabetes.
If you have a driving licence, write a letter to the DVLA telling them about your diabetes and how it is treated. If you are treated with insulin, you will be sent another form
(Diabetic 1) asking for more information. This includes the name and address of your General Practitioner or hospital doctor. They will also ask for your permission to approach these people directly, if necessary, to obtain information on your fitness to drive. This does not mean, however, that you will be refused a licence. If your diabetes is treated with insulin, a driving licence will be issued for one, two or three years, and will you allow you to drive a vehicle up to 3.5 tonnes. When this licence expires you will receive a reminder to renew the licence and you may also be sent another Diabetic 1 form to complete with more up-to-date information. Renewals are free of charge.
If your diabetes is treated with tablets, you are not always sent the Diabetic 1 form. In general, you will be issued with a full driving licence, providing that you do not have any other medical condition that might prevent this. There is a charge for renewing this licence after the age of 70. This is the same as for anyone else in the UK who does not have diabetes. If you have gestational diabetes and are put onto insulin temporarily, you need not inform the DVLA unless the insulin usage continues for more than 3 months or if you experience disabling hypoglycemia.
Applying for a C1/C1+E Licence
In order to apply for this licence, you must ensure that you meet the following qualifying conditions:
· No episodes of hypoglycemia which have required assistance whilst driving within the last 12 months. You must undertake to regularly monitor your blood sugar levels at least twice a day and at times relevant to your driving. If your application is successful, then you will need to continue to monitor in this way, particularly at times relevant to driving C1/C1+E vehicles.
· Every 12 months, you will need to arrange to be examined by a hospital consultant who specialises in diabetes. At the time of this examination, the consultant will need to review your blood glucose records for the previous 3-month period.
· You must have no other medical condition which would bar you from driving these vehicles
If you are unsure whether or not you are able to apply for this licence, contact the DVLA directly.
Application Pack for a C1/C1 + E Licence
The pack contains:
· Forms D1, D750 and DIABC1, which you will need to complete.
· Form D4. You will need to ask a doctor to complete this. This is needed at the first application for the licence and at 5-yearly intervals from the age of 45 until the age of 65, but thereafter it is required annually.
· Once the DVLA is satisfied with the application, a medical questionnaire (C1 exam) will be sent, and this must be completed by a consultant specialising in diabetes. You will have to pay any consultation fee charged for this examination. If this report is not satisfactory, your ordinary (category B) driving licence will be re-issued for a 1-year period with C1 entitlement.
· You will also be asked to arrange, and pay for, the completion of a medical questionnaire by a consultant specialising in diabetes, with each licence renewal.