Driving
- Diabetes with insulin treatment or any complications should be declared to DVLA.
- Driving licenses are then period-restricted – have to be renewed every 3 years
- The key risk to driving is hypoglycaemia which causes CNS problems- although visual impairment is also a problem
- If patient has had a hypose he cannot drive for a year
- Advice given:
- Check BM before journeys – should be ≥5mmol
- Stop driving at first signs of hypoglycaemia – i.e. hunger, autonomic hyperactivity
- Keep fast-acting carbs in the car – e.g. Lucozade
- Take regular snacks during driving.
Referral criteria
- Refer the following cases to specialist (i.e. a diabetologist in hospital setting):
- All children and pregnant women
- Complex cases – e.g. can’t diagnose the type and needs antibodies
- Developing complications – either long-term or short-term
- Short-term – urgent referral if DKA and then also refer neuropathy, nephropathy, HTN
- Long -term – would usually be managed by the podiatrist/opthalmologists already
- Must refer persistent proteinuria to renal diabetic team
- Refractory to treatment – i.e. failing to improve glycaemic control