l diabetes - yeovil hospital

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Understanding Diabetes Diabetes: l The law: Your responsibilities l Do I need to notify the DVLA? l Other circumstances l What if I have an accident? l Safe driving Safe driving and the DVLA What if I have an accident? l Having a hypo means that your blood glucose level is too low (<4 mmol/L). l Act IMMEDIATELY by eating or drinking something that will raise your blood glucose quickly. l Never ignore the warning signs. l Make sure other people know what to do when you are having a hypo. l Always carry glucose, a blood glucose meter and diabetes identification. Consequences of frequent hypos: l You may not recognise future hypos. l Fear and anxiety of getting further hypos. l Effects on employment and driving. If you are concerned about anything within this leaflet please discuss this with your healthcare professional. Remember … Further information l Diabetes UK careline: 0845 120 2960 l Diabetes UK: www.diabetes.org.uk l Driver and Vehicle Licensing Agency: www.directgov.uk l TREND-UK: www.trend-uk.org References 1. DVLA (2012) Information for drivers with diabetes treated by non insulin medication, diet, or both. DVLA, Swansea 2. Diabetes UK (2012) Driving and the New Medical Standards for People with Diabetes. Diabetes UK, London 3. Gallen I et al (2012) Driving and hypoglycaemia: questions and answers. Practical Diabetes 29: 13–14 The information in this leaflet has been reviewed by the DVLA (January 2012) and endorsed by the AA (May 2012). If you have an accident, even if you feel it is not your fault, test your blood glucose level to demonstrate whether or not you were hypo. If you have a hypo while driving, you may be charged with driving under the influence of a drug (insulin or diabetes tablet), driving without due care and attention, or dangerous driving. If you have a hypo at the wheel, you must inform the DVLA as soon as you can. Having diabetes does not mean that you have to give up driving ... Safe driving l Keep glucose treatments in the car within easy reach of driver at all times. l If you inject insulin, check your blood glucose before driving.You may need to do this if you take tablets that may cause hypos. Group 2 drivers (bus/ lorry) on a sulphonylurea or glinide are required by law to monitor their blood glucose level at least twice daily and at times relevant to driving. 1,2 l Do not drive if your blood glucose level is less than 5 mmol/L and you are taking a diabetes treatment that can cause hypos. 2,3 If so, have a small starchy snack, such as a couple of plain biscuits or a piece of fruit. l If you have a hypo while driving, stop the car as soon as possible. Remove the keys to demonstrate you are not in charge of the car, and move into the passenger seat if safe to do so.Treat the hypo as advised. You should not drive for at least 45 minutes after recovery because your response rate will be slower. The printing and distribution of this leaflet was funded by MSD Diabetes.The content was generated independently by TREND-UK in conjunction with SB Communications Group. MSD had the opportunity to review for compliance and medical accuracy only. MSD had the opportunity to review for compliance and medical accuracy only.

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Page 1: l Diabetes - Yeovil Hospital

Understanding Diabetes

Diabetes:

lThe law: Your responsibilities

lDo I need to notify the DVLA?

lOther circumstances

lWhat if I have an accident?

l Safe driving

Safe driving and the DVLA

What if I have an accident?lHavingahypomeansthatyourbloodglucoselevelistoolow(<4mmol/L).

lActIMMEDIATELYbyeatingordrinkingsomethingthatwillraiseyourbloodglucosequickly.

lNeverignorethewarningsigns.lMakesureotherpeopleknowwhattodowhenyouarehavingahypo.

lAlwayscarryglucose,abloodglucosemeteranddiabetesidentification.

Consequences of frequent hypos:lYoumaynotrecognisefuturehypos.lFearandanxietyofgettingfurtherhypos.lEffectsonemploymentanddriving.If you are concerned about anything within this leaflet please discuss this with your healthcare professional.

Remember …

Further informationlDiabetesUKcareline:08451202960lDiabetesUK:www.diabetes.org.uklDriverandVehicleLicensingAgency: www.directgov.uklTREND-UK:www.trend-uk.orgReferences1.DVLA(2012)Informationfordriverswithdiabetestreatedbynoninsulinmedication,diet,orboth.DVLA,Swansea

2.DiabetesUK(2012)Driving and the New Medical Standards for People with Diabetes.DiabetesUK,London

3.GallenIetal(2012)Drivingandhypoglycaemia:questionsandanswers.Practical Diabetes29:13–14

TheinformationinthisleaflethasbeenreviewedbytheDVLA(January2012)and

endorsedbytheAA(May2012).

Ifyouhaveanaccident,evenifyoufeelitisnotyourfault,testyourbloodglucoseleveltodemonstratewhetherornotyouwerehypo.

Ifyouhaveahypowhiledriving,youmaybechargedwithdrivingundertheinfluenceofadrug(insulinordiabetestablet),drivingwithoutduecareandattention,ordangerousdriving.Ifyouhaveahypoatthewheel,youmustinformtheDVLAassoonasyoucan.

Havingdiabetesdoesnotmeanthatyouhave

togiveupdriving...” “Safe drivinglKeepglucosetreatmentsinthecarwithineasyreachofdriveratalltimes.

lIfyouinjectinsulin,checkyourbloodglucosebeforedriving.Youmayneedtodothisifyoutaketabletsthatmaycausehypos.Group2drivers(bus/lorry)onasulphonylureaorglinidearerequiredbylawtomonitortheirbloodglucoselevelatleasttwicedailyandattimesrelevanttodriving.1,2

lDonotdriveifyourbloodglucoselevelislessthan5mmol/Landyouaretakingadiabetestreatmentthatcancausehypos.2,3Ifso,haveasmallstarchysnack,suchasacoupleofplainbiscuitsorapieceoffruit.

lIfyouhaveahypowhiledriving,stopthecarassoonaspossible.Removethekeystodemonstrateyouarenotinchargeofthecar,andmoveintothepassengerseatifsafetodoso.Treatthehypoasadvised.

You should not drive for at least 45 minutes after recovery because your response rate will be slower.

TheprintinganddistributionofthisleafletwasfundedbyMSDDiabetes.ThecontentwasgeneratedindependentlybyTREND-UKinconjunctionwithSBCommunicationsGroup.

MSDhadtheopportunitytoreviewforcomplianceandmedicalaccuracyonly.

MSDhadtheopportunitytoreviewforcomplianceandmedicalaccuracyonly.

Page 2: l Diabetes - Yeovil Hospital

Do I need to notify the DVLA?Hypoglycaemicepisodes(“hypos”)

arewhenyourbloodglucoselevelsaretoolow,whichcanleadtoconfusionandaffectyourabilitytodrive.Thiscanincreasetheriskofaccidents,whichbarssomepeoplefromdriving.Havingdiabetesdoesnotmeanthatyouhavetogiveupdriving,butitdoesmeanthatyouneedtoplaninadvancebeforeyougetbehindthewheel.Complicationsassociatedwithdiabetescanaffectyourabilitytodrive,aswellasyourriskandawarenessofhypos.

Thefollowinginformationassumestherearenoothercircumstancesthataffectyourabilitytodrivesafely,particularlyregardingyourriskof,andyourabilitytodetect,hypos(lowbloodglucoselevels).Ifyouareunsurewhatahypois,orwhichcategoryyourdiabetesmedicationisin,askyourpharmacistoryourdiabeteshealthcareprofessional.

The law: Your responsibilities

Other circumstancesYourabilitytorecogniseandtreathypos,andthedevelopmentofdiabetescomplications,mayaffectyourabilitytodrivesafely.Bylaw,youmustinformtheDVLAwhenthefollowingaffectyou(evenifyouareonlytakingmedicationsthatfallinthe“NO”boxmentionedpreviously):1

lYouneedlasertreatmenttobotheyes,orintheremainingeyeifyouhavesightinoneeyeonly.

lYouareunabletoread(withglassesorcontactlensesifnecessary)acarnumberplateat20.5metres(67feet)or20metres(65feet)wherenarrowercharactersareused.

lYoudevelopanyproblemswiththecirculationorsensationinyourlegsorfeetthatmakesitnecessaryforyoutodrivecertaintypesofvehiclesonly(e.g.automaticvehiclesorvehicleswithahand-operatedacceleratororbrake).

lYousufferfrommorethanoneepisodeofdisablinghypoglycaemia(needinghelpfromanotherperson)within12months,orifyouoryourcarerfeelyouareathighriskofdevelopingdisablinghypoglycaemia.ForGroup2drivers(bus/lorry),oneepisodeofseverehypoglycaemiamustbereportedimmediately.

lYoudevelopimpairedawarenessofhypoglycaemia(delayordifficultyinrecognisingthewarningsymptomsoflowbloodglucose).

lYousufferdisablinghypoglycaemiawhiledriving.lAnexistingmedicalconditiongetsworseoryoudevelopanyotherconditionthatmayaffectyoudrivingsafely.

Nb.Itisadvisabletoinformyourmotorinsurancecompanyifyouhavediabetestoavoidanyproblemsshouldanaccidentoccur.

IfyouareonadiabetesmedicationthatrequiresyoutoinformtheDVLA,itisyourresponsibilitytodoso.Yourdiabetestreatmentsandcircumstancesmaychangeovertime,socheckifthisaffectsyourabilitytodriveandwhetheryouneedtocontacttheDVLA.

ThelawregardingdrivingGroup2vehicleswhenusinginsulinhaschanged.Ifyoucandemonstratethatyoumeetthefollowingcriteria,thenyoumayapplytodriveGroup2vehicles:1–3

lYouhavewell-controlleddiabetes(withevidencefrom3monthsofresultsonabloodglucosemetermemory).

lYouhavehadnoepisodesofseverehypoglycaemia(needingthehelpofanotherperson).

lYouhaveearlywarningsymptomswhenyourbloodglucosebeginstodroptolowlevels.

Formoreinformation,contacttheDVLAanddiscusswithyourdiabeteshealthcareprofessional.

Yourdiabetes Group1 Group2treatment (car, (LGV/PCV) motorcycle)

Managedbydietalone NO NO

Tabletsnotincluded NO YESbelow.Thesehavealowriskofcausinghypos

Non-insulininjections, NO YESunlessyouarealsotakingoneofthetabletsbelow

TabletsthatcarryariskNO YESofhypos.Thisincludessulphonylureas,suchasgliclazide,andglinides(repaglinideandnateglinide)

Insulin YES YES

Temporaryinsulin NO YES(e.g.followingaheartattackorduringgestationaldiabetes)

If you have a hypo while driving, stop the car as soon as possible. Remove the keys to demonstrate you are not in charge of the car, and move into the passenger seat if safe to do so. Treat the hypo as advised.