Ask the Doctors

Dear Doctor: Whenever I offer a certain friend a ride, she kindly declines, explaining that, because I have Type 1 diabetes, she's afraid my blood sugar will suddenly crash and I'll get into an accident. I know it's just ignorance and try not to be insulted. Can you help explain why most people with diabetes are OK to drive?

Dear Reader: It's true that people living with Type 1 diabetes run the risk of hypoglycemia, which is when blood sugar becomes dangerously low. This can lead to physical reactions that would make driving dangerous.

The early warning signs of hypoglycemia include shakiness, dizziness, hunger, mood swings, headache, sweating and anxiety. If left untreated, hypoglycemia can lead to blurred vision and slurred speech, jerky or uncontrolled movements, confusion or muscle weakness. At its most extreme, it can cause seizures or convulsions and result in death.

However, when diabetes is properly managed, serious episodes of hypoglycemia tend to be infrequent. The majority of people with Type 1 diabetes who adhere to specific safe-driving guidelines drive regularly without medically related incidents. By remaining vigilant about blood glucose monitoring and being prepared for a quick correction by eating a fast-acting sugar snack, most people with diabetes can successfully manage an episode of hypoglycemia.

We agree that your friend's fears stem from a lack of knowledge about diabetes. Perhaps learning about the precautions set out by the American Diabetes Association, with an eye to helping people with diabetes live full and safe lives, will give your friend some peace of mind?

-- Before you set out on a drive, check your blood glucose. On longer trips, it's important to stop and do periodic checks to be sure you're in the optimal range.

-- Make it a habit to stock the car with a special driving kit. Include your blood glucose meter and lots of snacks, including several that are quick-acting sources of sugar. Hard candy, fruit juice or glucose tablets will do the trick.

-- Are you feeling any of the signs of hypoglycemia during your drive? Pull over immediately (seriously, immediately, because things can go wrong so quickly), and check your blood glucose level.

-- Is your blood glucose low? That's the time for one of those fast-acting sugar sources. Take a 15-minute break and do another check. If you're in the zone, it's OK to start driving again.

-- It's very important to stay current on eye exams, so you can catch any diabetes-related vision problems as quickly as possible.

There is one very important caveat.

If you have experienced an episode of hypoglycemia unawareness, which is when you are unable to detect the warning signs that your blood glucose is low, you must give up driving until awareness has been re-established. This is for your own safety, and for those around you. Call your doctor to talk about treatment strategies.

So ask yourself: Is your diabetes under control? Are you able to quickly detect and promptly respond to an episode of hypoglycemia? Will you follow the ADA's driving guidelines? If so, you can reassure your friend about your ability to take the wheel.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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