Driving and Diabetes: A Summary of the Current Medical and Legal Position Based Upon a Recent Heavy Goods Vehicle (HGV) Case

The problems associated with the driving of motor vehicles by insulin-treated diabetics (ITD) continue to present difficulties and provoke controversy. Having supported an insulin-treated driver of a Heavy Goods Vehicle (HGV), whose licence was revoked by the Area Licensing Authority on the advice of the Medical Advisers at the Department of Transport, we considered in detail the medical and legal factors pertaining to driving. The case in question was taken to the High Court on an important point of Law’ and, as a result, enabled the driver to retain his HGV licence. This article reviews the medical literature and the current legal position with particular reference to HGV driving. The problems associated with diabetes which may produce a hazard while driving are impaired vision, neuropathy and cardiovascular complications. The major potential metabolic hazard for the insulin-treated diabetic is hypoglycaemia. The unpredictable and potentially dramatic nature of hypoglycaemia makes this risk to driving much more difficult to evaluate than chronic complications. Instances of hypoglycaemic attacks occurring at the wheel have been reported but these reports do not allow evaluation of the overall risks presented by ITDs compared with non-diabetic drivers. Hypoglycaemia can also be experienced by non-diabetics and reports exist where accidents have occurred as a result. In a review of the published work, we have attempted to evaluate the overall level of risk presented by diabetic drivers with particular reference to hypoglycaemia, considered this in the context of the current law relating both to ordinary and to HGV diabetic drivers.