Diabetes
and Driving
This is an overview of driving with diabetes. The
complete standards are published in Sláinte agus
Tiomáint: Medical Fitness to Drive (MFTD) Guidelines.
NDLS
What is Diabetes?
Diabetes mellitus is a lifelong condition caused by
a lack of insulin in your body. Insulin is a hormone
that regulates blood glucose (sugar). If some of the
treatments for diabetes (particularly insulin and certain
types of the tablets) are not managed properly, this can
cause ‘hypoglycaemia’ – low blood sugar levels. An
episode of hypoglycaemia is sometimes called ‘a hypo’.
Hypoglycaemia makes you feel unwell and can affect
your ability to drive safely. If you suffer a severe hypo,
it means you need someone to help you – you could
become dizzy or drowsy and you need to get your sugar
levels under control. In severe cases, you could lose
consciousness. The risk of a hypo is the main danger to
safe driving for people with diabetes. The risk increases
the longer you are on insulin treatment.
If you get warning symptoms of a hypo whilst driving,
you must always stop as soon as it is possible to do so
safely. Do not ignore the warning symptoms.
Note: You are committing an offence if you carry on
driving after you become aware that you are not fit to
do so. ‘Awareness’ can be your own awareness – that is,
things you notice yourself without being diagnosed by
a doctor. Awareness can also be as a result of a warning
not to drive from your doctor.
Why is health important for
drivers?
Your health is important, as driving any motor vehicle
requires:
n constant attention;
n good judgement;
n appropriate responsiveness;
n reasonable perception and physical capability; and
n good senses – for example, sight and hearing.
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Why is it important that I am fully
fit to drive?
n The Road Safety Authority (RSA) and the National
Driver Licence Service (NDLS) aim to minimise the
risk caused by any medical condition you might
have both to you and to the community. Indeed, for
many conditions, treatment and rehabilitation may
improve your safety when driving.
n We also want to give consideration to your
social, lifestyle and employment-related mobility
and independence. Our aim is to help you be as
independently mobile as possible for as long as
possible. However, it is important to strike the right
balance between mobility and safety for drivers, their
families and other road users.
n If you drive against advice, and evidence is found
of this, the NDLS and the Gardaí will take action to
revoke your licence. If you are involved in a crash
or stopped by a member of An Garda Síochána, you
may be asked to prove you are in full control of your
vehicle. A charge can be brought against you even if
you don’t have a crash. If you cause harm to a person
or property, the charge will be more serious. In these
circumstances, driving becomes a statutory offence
that may lead to a prison sentence. Finally, driving
against medical advice will affect your car insurance.
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What are the early warning
symptoms of Hypoglycaemia?
The early symptoms include:
n sweating
n shakiness or trembling
n feeling weak or hungry
n fast pulse or palpitations
n anxiety
n tingling lips
If you do not get treatment for these early signs, you may
experience more severe symptoms such as:
n slurred speech
n difficulty concentrating
n confusion
n disorderly or irrational behaviour, which may be
mistaken for drunkenness
If left untreated, you could lose consciousness.
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Managing insulin-treated diabetes
and driving
Drivers with insulin-treated diabetes are advised to take
the following precautions to manage their condition
and drive safely.
Carry
Always carry your glucose meter and blood glucose strips
with you. You must check your blood glucose before
driving and every two hours whilst driving. Also, always
carry personal identification to show that you have
diabetes in case of injury in a road traffic accident.
Measure
Blood glucose is measured in ‘millimoles per litre’ and is
written as mmol/l. If your blood glucose is 5.0 mmol/l or
less, have a snack. If it is less than 4.0 mmol/l or you feel
hypoglycaemic, do not drive. Take appropriate action.
Retest to ensure your blood glucose is above 5.1 mmol/l.
Stop
If you develop hypoglycaemia while driving, stop your
vehicle as soon as possible.
Wait
Switch off the engine, take the keys out of the ignition,
and move from the driver’s seat. Do not drive again until
45 minutes after your blood glucose level has returned to
normal. It takes up to 45 minutes for the brain to recover
fully.
Keep
Keep an emergency supply of fast-acting carbohydrate,
such as glucose tablets or sweets, within easy reach in
your vehicle.
Take
Always take regular meals, snacks and rest periods at
least every two hours on long journeys.
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Avoid
Always avoid alcohol.
IMPORTANT
Please make sure that your meter displays the correct
time and date so that you have a record.
Driver Guidelines
Group 1 – Driving a car, motor cycle or
tractor
If you are a Group 1 driver, you must inform NDLS if:
n you suffer more than one episode of severe
hypoglycaemia (where you need someone to help
you) within the last 12 months.
Group 2 – Driving a bus or truck
If you are a Group 2 driver, you must inform NDLS if:
n you suffer one episode of severe hypoglycaemia;
n your medical team feels you are at high risk of
developing hypoglycaemia;
n you begin to have difficulty in recognising warning
symptoms of low blood sugar (impaired awareness
of hypoglycaemia);
n you suffer severe hypoglycaemia while driving;
n an existing medical condition gets worse, or you
develop any other condition that may affect safe
driving.
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If you are a Group 1 or Group 2 driver applying for, or
renewing your licence, or if you have been diagnosed
with diabetes, you must inform NDLS if:
n you are treated by insulin, or if your diabetes is
managed by tablets which carry a risk of inducing
hypoglycaemia (bringing on a hypo attack), for
example sulphonylureas. (Ask your doctor whether
you are on sulphonylureas or other medications
which carry a risk of inducing hypoglycaemia.)
n you develop any problems with your circulation
or sensation in your legs or feet which makes it
necessary for you to drive certain types of vehicles
only (for example, automatic vehicles or adapted
vehicles).
If you are on temporary insulin treatment, you should
consult with your doctor as to whether or not you must
notify the NDLS.
There is no need to notify the NDLS if your diabetes is
managed by diet alone, or only by medications which
do not carry a risk of inducing hypoglycaemia.
Diabetes and eyesight
n Diabetes may affect your eyesight. You should have
an eye test at least every year carried out by a doctor
or optometrist or orthoptist. They might recommend
that you have more frequent tests at regular
intervals. These tests should be a full examination
including the back of the eye.
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What will happen if I continue to
drive?
It is important to strike a balance between mobility and
safety. If you continue to drive against medical advice or
ignore early warning symptoms, and evidence is found of
this, it will affect your insurance, and the NDLS and the
Gardaí will take action to revoke (cancel) your licence.
Be a responsible driver
It is your responsibility as a driver to:
n follow your doctor’s advice
n take your prescribed medication correctly and
consistently
n monitor and manage your medical condition(s)
n tell the NDLS and your insurance provider if you have
a long-term or permanent injury or illness that may
affect your ability to drive safely
n meet the requirements of your licence, including
going for regular medical check-ups to make sure that
your symptoms are managed well for safe driving
n get professional medical advice on your medical
fitness to drive, which might include training with
an On-Road Driving Assessor (ORDA) or Occupational
Therapist (OT)
n get further professional medical advice if you develop
a new medical condition or if your medical condition
changes.
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If I need to, how do I inform the
NDLS?
If following a consultation with your doctor, your medical
condition is one that must be notified to the NDLS you
will need to have a medical report form completed and
make an application for a change of personal (medical)
details. This can be done by
n applying in person at an NDLS centre,
which is by appointment only. Please see
www.ndls.ie/how-to-apply/applying-in-person
n applying online*, provided you have a Public Services
Card and a verified MyGovID account.
*If you have a code 101 on your existing licence and you are
not renewing and you wish to update your medical details
you will need to attend an NDLS centre to have this done.
The NDLS does not accept notifications of medical
conditions by email or post.
For further information, please see
www.ndls.ie/medical-fitness
If you have more questions, please email
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Further information:
n Your GP or nurse.
n Diabetes Ireland is a valuable source of support
and information.
Web: www.diabetes.ie
Helpline: 1850 909 909
Email: [email protected]
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NDLS
NDLS
April 2022
