7 Questions Answered About Driving With Type 1 Diabetes

7 Questions Answered About Driving With Type 1 Diabetes
-Interview by Shahd Husein
We’re answering questions about type 1 diabetes management in a Q&A series featuring diabetes care and education specialists (CDEs).
Today, we hear from Julie Kincheloe, RN, CDE, who has worked with the diabetes team at Children’s Mercy Kansas City since 2015. Diagnosed with type 1 diabetes in 2007, she is passionate about helping others live successfully with diabetes.
The team at Children’s Mercy actively participates in the T1D Exchange Quality Improvement Collaborative.
What general tips would you offer individuals with type 1 diabetes to stay safe while driving?

  • Always have snacks with you and within reach.
  • Keep with you low treatment snacks (with quick carbohydrates), as well as protein- and carbohydrate-rich foods (for longer rides).
  • Know and be aware of hypoglycemic symptoms. 
  • If driving for a longer period of time, take frequent breaks to stop and check your blood glucose, or eat as needed.
  • it’s very important to wear a medical ID or have something in your car that states that you have diabetes. If you don’t have a medical ID, use a seatbelt cover that states you have diabetes. 

How long before driving should an individual with type 1 diabetes check their blood glucose levels? 
You should check your blood glucose immediately before driving. How often you check your blood glucose during the journey will depend on many factors. Consider all the usual factors for blood sugar variability, like when you last dosed fast-acting insulin and time elapsed since your last snack or meal. 
What should one do if they experience low blood sugar while driving?
Stop, pull over safely, and check your blood glucose. Treat hypoglycemia and wait to get back on the road until your blood glucose is in target and your symptoms are gone. 

How do driving laws affect individuals with type 1 diabetes?
Driving laws vary by state. Individuals with diabetes should be aware of the laws in their state by going to the ADA database on this subject.
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In any state, an individual who has experienced hypoglycemia while driving may be evaluated for their ability to drive safely in the future. This could occur if there has been an accident or if they were pulled over by police due to erratic driving.

What spare supplies would you recommend keeping in the car?
Along with the snacks listed above, it is a good idea to have extra test strips, lancets, pen needles, and insulin with you. If you wear a pump, you should keep batteries and extra pump supplies with you. Finally, remember to never leave your insulin in your car, where it could get too hot or too cold.

For individuals who experience hypoglycemia unawareness, what would you recommend for staying safe on the road?
The best recommendation is to use a continuous glucose monitor (CGM). Your physician’s office could facilitate approval of the device if denied by insurance. If this is not an option, I would recommend checking your blood glucose at least every two hours while driving.
Why is a medical ID a good idea for people with type 1 diabetes while they are driving?
There have been many incidents where law enforcement have mistaken hypoglycemia symptoms for misconduct. It is very important to have a medical ID on your body or visible in your car with your medical information. Many states are improving the education for law enforcement officers related to many medical conditions including diabetes, but the more information you can provide in the moment, the quicker you can receive help, if needed.
Editor’s note: Keep trying to communicate with the police in as calm a manner as possible if you are experiencing hypoglycemia, especially if it is being mistaken for something else. You have the right to medical attention, but you also should refrain from being aggressive towards a police officer. 
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