For many people, driving is a daily necessity. Your most convenient option may be to drive yourself to work or important appointments or to drive your kids to and from school. The ability to drive can open doors socially, educationally, and professionally.

A diabetes diagnosis doesn’t automatically make driving unsafe, and many people with diabetes drive every day. However, some diabetes symptoms and complications can cause concern about driving safety.

In this article, we’ll discuss how diabetes can affect your ability to drive, how to keep yourself and others safe while on the road, and legal guidelines around driving with diabetes.

Risks of Driving With Diabetes

Most people living with diabetes have safe driving records, and their driving isn’t a particular risk to themselves, their passengers, or other drivers. Their overall risk of getting into an accident isn’t much different from the general population’s risk. But complications of unmanaged diabetes can be risky on the road.

Low Blood Sugar

Most safety risks of driving with diabetes are from hypoglycemia (low glucose, or blood sugar). A drop in blood sugar can occur without any obvious signs.

There are three levels of hypoglycemia, with glucose measured in milligrams per deciliter (mg/dL):

• Level 1 hypoglycemia — Glucose between 54 mg/dL and 70 mg/dL
• Level 2 hypoglycemia — Glucose less than 54 mg/dL
• Level 3 hypoglycemia — Any severe drop in blood sugar that causes symptoms (glucose level varies)

Level 2 hypoglycemia and level 3 hypoglycemia can both make driving more dangerous by affecting your cognitive ability, including your reaction time and hand-eye coordination. Hypoglycemia can also cause blurry vision or seizures while driving because your brain does not have enough glucose to function properly.

Blood Sugar Spikes

In rare cases, an extreme blood sugar spike may also affect your motor skills and vision. Therefore, hyperglycemia (high blood sugar) might also pose risks while driving.

However, according to the American Diabetes Association, there isn’t enough evidence that blood sugar spikes affect driving ability to confirm hyperglycemia as a significant risk to driving safety.

Diabetes Symptoms and Complications

While a spike in your blood sugar might not affect your driving safety, some complications of long-term hyperglycemia might.

Blurry Vision

Over time, long-term high blood sugar from diabetes can affect your eyes and cause complications like cataracts and diabetic retinopathy. These conditions can cause blurry vision, vision changes, or even blindness if left untreated.

Neuropathy

There are several causes of neuropathy, but diabetic neuropathy can occur when you have high blood sugar for a long time, which then causes damage to your nerves. The most common type is peripheral neuropathy, which affects nerves outside your brain and spinal cord.

The main symptoms of diabetes-related peripheral neuropathy are pain, weakness, or numbness in your legs, feet, and sometimes hands. Weak, numb, and pained legs can make it difficult to use your car’s pedals while driving.

Safety Steps for Drivers With Diabetes

Although car accidents related to diabetes and diabetes complications are rare, it’s wise to take certain precautions to avoid diabetes-related issues that might cause an accident.

The most important step you can take is managing your diabetes according to your diabetes care plan, including timing your insulin properly. Talk to your healthcare provider about how to stabilize your blood sugar to make driving safer.

Other safety precautions for driving with diabetes include:

• Testing your blood sugar regularly — Test your glucose levels before you get in the car and monitor them during long drives. A continuous glucose monitor (CGM) helps you do this safely.
• Pulling over to test your glucose if you feel low — Don’t start driving again until your glucose levels are within a safe range.
• Keeping carbohydrates in the car — Keep ready-to-eat snacks with you when driving in case of low blood sugar.
• Keeping supplies in your car — Prepare for an emergency by keeping glucagon, test strips, and other supplies for testing or managing your blood sugar on hand.
• Identifying your condition — If you have a diabetes medical ID or diabetes medical alert bracelet, keep it on you while driving so first responders can find it in case of an emergency.

Diabetes and Driving Laws

The U.S. federal government has no restrictions for drivers with diabetes who manage their condition and see their healthcare provider regularly. However, some states have rules about getting your driver’s license when you have a condition like diabetes. You can find out your state’s requirements by contacting your department of motor vehicles (DMV) or visiting its website.

If your hypoglycemia causes an accident, your state’s licensing authorities might intervene and restrict or revoke your license. If you experience severe hypoglycemia regularly but haven’t yet been in a car accident because of it, doctors may notify the state’s licensing authorities, too.

Commercial Driving and Diabetes

Getting and maintaining a commercial driver’s license isn’t the same as getting a personal driver’s license. If you have diabetes, you may still be able to have a commercial driver’s license as long as you follow specific guidelines.

If you have diabetes and can pass your state’s medical evaluation, you can get a Department of Transportation medical certification for a commercial driver’s license.

Join the Conversation

On DiabetesTeam, people share their experiences with diabetes, get advice, and find support from others who understand.

Which steps do you take to make driving with diabetes safer? Let others know in the comments below.