1. Diabetes
DVLA and Sick day rules

2. When to inform DVLA

Diabetes with relevant complication (e.g.
retinopathy/neuropathy)

Must be able to read with glasses or contacts a car
number plate in good light at 20 metres

Circulation/sensation problems of legs/feet

Drivers on insulin (no need to inform if on tablets
and/or diet)

Just started to take insulin and diabetes is not yet
properly controlled

More than one episode of severe hypoglycaemia
(require assistance) within 12 months or at risk of it

Impaired awareness of hypoglycaemia

3. Hypoglycaemia

『 DRIVING UNDER INFLUENCE OF DRUGS 』

Insulin, Sulfonylurea, Meglitinide

Know the warning signs - palpitation, sweating etc.

Bring glucometer

Check sugar levels before driving (BM < 4.0mmol/L or feel hypoglycaemic) – DO NOT DRIVE

Check every 2 hours if long trip

Impaired awareness?

Always carry glucose (e.g. fruit) and consume when warning signs appear

Tell your passenger what to do if help is needed

Stop driving as soon as it is safe to do so

Do not start driving until symptoms disappear or 45 minutes after BM is back to normal

4. Vision

Field loss

Central or peripheral

Minor or severe

Glare

Sunglasses

5. Group 1 (cars and
motorcycles)
Group 2 (lorries, buses,
minibuses etc.)
IDDM License retained if visual
requirement is met and can
recognise symptoms of
hypoglycaemia
Barred from driving
Frequent
hypoglycaemia/impaired
awareness
Revoked until satisfactory
control
Barred from driving
Visual field/acuity defect Eyesight requirement. +
national guidelines for
visual field
Barred from driving
Limb disability Inform DVLA –
modifications
Individual assessment

6. Sick Day Rules

During illness → BM +, therefore, never stop taking
insulin/tablets

Continue with normal diet

Plenty of fluids (preferably sugar-free), especially if
on metformin

Consider anti-emetic if vomiting/diarrhoea

7. Testing ketones and BM

If type 1 DM: Test urine/blood ketones

Test BM at least 4 times/day – insulin dose
adjustment with an aim of 4-10mmol/L

<10 usual dose

10-15 +6 U of quick-acting insulin

15-20 + 8 U of quick-acting insulin

>20 + 10 U of quick-acting insulin

8. Hospital admission if...

Inability to swallow or keep fluids down

Persistent vomiting/ diarrhoea

Persistently raised glucose (>25 mmol/L)
despite increasing insulin

++++ Ketonuria

Ketoacidosis (dehydration, abdominal pain etc.)