Driving and diabetes: problems, licensing restrictions and recommendations for safe driving

Many complications of diabetes can potentially impair driving performance, including those affecting vision, cognition and peripheral neural function. Hypoglycemia is a common side-effect of insulin and sulfonylurea therapy, impairing many cognitive domains necessary for safe driving performance.

Driving simulator studies have demonstrated how driving performance deteriorates during hypoglycemia. Studies examining the risk of road traffic accidents in people with insulin-treated diabetes have produced conflicting results, but the potential risk of hypoglycemia-related road traffic accidents has led to many countries imposing restrictions on the type and duration of driving licenses that can be issued to drivers with diabetes.

This paper examines driving behaviour that may predispose to hypoglycemia while driving, and reviews guidance that promotes safe driving practice which has been provided for drivers with insulin-treated diabetes, which is the group principally addressed in this review.