Diabetes and Driving
There have recently been some important changes regarding driving and diabetes.
As a result of changes in EU law in August 2009, DVLA has been considering changes to the riving regulations for people with diabetes. The DVLA proposals eventually went out to consultation which ended on April 28 2011 and changes to the regulations came into effect in October 2011. The new regulations were more relaxed for group 2 entitlement enabling insulin-treated or tablet treated diabetics to be eligible to apply for a Group 2 license providing they satisfied the following criteria:
• No episode of hypoglycaemia requiring the assistance of another person has occurred in the preceding 12 months
• Has full awareness of hypoglycaemia
• Regularly monitors blood sugars at least twice daily and at times relevant to driving using a glucose meter with a memory function to measure and record blood glucose levels. At the annual examination by an independent Consultant Diabetologist, 3 months of blood glucose readings must be available.
• Must demonstrate an understanding of the risks of hypoglycaemia
• There are no debarring complications of diabetes such as a visual field loss
If an applicant meets this criteria, a one year licence can be issued. DVLA has announced that it will cover the costs of the individual medical assessment for people with diabetes wishing to apply for group 2 entitlement.
However the new regulations did also introduce further guidance for all drivers relating to hypoglycaemic episodes. The changes to the standards for insulin-treated diabetics related to group 1 entitlement are:
• Must not have had more one episode of hypoglycaemia requiring the assistance of another person in the preceding 12 months
• Must have awareness of hypoglycaemia
• There must be appropriate blood glucose monitoring
• Must not be regarded as a likely source of danger to the public while driving
• The visual standards for acuity and visual fields must be met
• here are no debarring complications of diabetes such as a visual field loss
Since the introduction of the new regulations and guidance, there have been many complaints that the current regulations are both confusing and that the EU rules are being interpreted too harshly by DVLA. As a consequence, driving licence application forms for people with diabetes are to be rewritten. The DVLA has agreed to rewrite the forms to clarify how sever a hypo has to be to be declared. The DVLA have stated that:
• “we are awaiting clarification from the European Commission to confirm our understanding of the interpretation of the minimum standards required by drivers.”
• “we must apply European medical standards but we consider every case individually and only refuse licences where absolutely necessary”
A working group has been set up to debate this further and the working group includes DVLA, individuals with diabetes and Diabetes UK. The expectation is that DVLA will make changes to the licence application form and will produce clearer guidance for people about what they need to report to the DVLA.
The DVLA guidance does also specifically state that ‘The Secretary of State’s Honorary Medical Advisory Panel on Diabetes and Driving has recommended that drivers with insulin treated diabetes should not drive emergency vehicles. This takes account of the difficulties for an individual regardless of whether they appear to have exemplary glycaemic control, in adhering to the monitoring processes required when responding to emergency situations.’
The DVLA ‘At a glance’ document can be downloaded from www.dft.gov.uk/dvla/medical/ataglance.aspx
The DVLA website provides more information for drivers at www.direct.gov.uk/driverhealth
DiscussionIt is important for employers and in particular occupational health professionals to keep up to date with DVLA guidance. Employers should make employees with diabetes aware of the changes and make them aware of their obligation to inform DVLA if they have hypoglycaemic episodes.
Employers may wish to incorporate the new regulations into policies for drivers or fork lift drivers. Healthwork would be happy to advise employers about the new regulations.