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The effects of diabetes on the motor industry

By Roger Ball
Director of Motor

If you're feeling tired, thirsty or taking frequent trips to the loo then you might be one of the 3.5 million in the UK who has diabetes. This article explains more about the condition and the effects it can have on those who get behind the wheel; both medically and legally.

The problem

First of all, some statistics: Every day in the UK 400 people are diagnosed with diabetes. Approximately 590,000 people are unaware they have the condition and by 2025 it is predicted that over five million will be classed as diabetic. The numbers are staggering and given the disease's association with obesity – another potential health epidemic – it looks like an issue that won't be going away any time soon.

Simply explained, diabetes is where the body fails to absorb glucose from food, creating a range of health complications and symptoms that range from extreme tiredness and slow wound healing to heart failure and fatal hypoglycaemic episodes.

The condition is divided into two fairly well-known types: Type 1 and Type 2; with the former being the more serious strand often involving the self-administration of insulin to maintain blood sugar levels, the latter is the more common type accounting for 80 per cent of cases, here the condition can be treated through regular exercise and a healthy diet.

Susceptible workers

However, keeping an eye on what we eat and taking regular exercise can be tricky for those in certain types of employment, for example, Heavy Goods Vehicle (HGV) drivers: Long, unnatural hours, a confined driving area and grabbing a sugary snack to get back on the M4 can create an unhealthy working environment and increases the chances of developing Type 2 diabetes.

For those fleet managers who oversee a team of HGV drivers it is certainly worth taking time to understand the causes, symptoms and treatment of the condition. Fairly stringent legislation also exists when it comes to those who have diabetes and drive commercially. The size and nature of buses, coaches and HGV – vehicles of a commercial nature – means that the risk is more substantial. Fleet managers of this type have a responsibility therefore to ensure that their drivers are medically fit to drive, which includes diabetic management.

The key here is declaration. The DVLA (DVI in Northern Ireland) requires notification if a driver with diabetes treats their condition with insulin. Bus, coach or lorry drivers should fill out a VD1AB1 and take a look at the helpful INS186 guidance document. Car drivers and motorcyclists who self-administer should be directed to the DIAB1 form.

Of course, insulin is not the only form of diabetic treatment, and those who medicate with sulphonylurea or glinide tablets also need to declare this. The VDIAB1SG form is the required administration here. Those who use non-insulin injections should fill out a VDIAB1GEN.

Despite this layer of legislation, diabetes is not necessarily a barrier to driving. Legally, drivers are required to read a vehicle registration plate from 20 metres and have a field of vision up to at least 120 degrees, and provided these can be achieved,  visual issues such as the loss of sight in one eye and even cataracts (both common diabetic complications) doesn’t mean driving isn’t legally permitted.. However, if someone has received laser eye surgery to correct these complications, then the DVLA need to be informed. Those driving HGV’s and passenger carrying vehicles who have had the procedure will be subject to tighter requirements.

Health risks

It's not surprising to learn that those with Type 2 diabetes are more susceptible to cardiovascular issues owing to higher levels of blood pressure and cholesterol and if these become present then the DVLA will again need to be made aware. Likewise, nerve damage and poor circulation - another complication of the condition - should be declared as this could affect feet and legs and therefore driving competency.

More stringent legislation is in place for drivers who have suffered in the past with severe hypoglycaemia episodes. These 'hypos' occur when blood sugar suddenly, and often without warning, drops below zero and leads to a diabetic fit or coma. Of course, the dangers of being behind the wheel when such an episode occurs are obvious and, it is for this reason that bus, coach or lorry drivers must inform the DVLA immediately if they have experienced a hypo outside of work that has required assistance. It's slightly different for car drivers or motorcyclists who should make the DVLA aware if they have experienced one or more hypo in the last 12 months.

The consequences of failing to declare this level of the condition ranges from a £1,000 fine or at its extreme, a prosecution. In 2011, a Scottish court heard that a driver who had a diabetic fit at the wheel causing the death of one women and seriously injuring another had failed to declare his condition and should not have been driving. The man was sentenced to six years in jail and banned from driving for ten.

Prevention

Accidents like the above are rare but they can and do occur. Of course, the key – like most risk prevention strategies – is to prevent the risk from happening in the first place. As mentioned, understanding the condition fully, particularly its symptoms and complications can make it easier to communicate with any employee who could potentially be at risk of the disease. Suggesting ways of being slightly healthier in the driving cab, such as exercise breaks or healthy food options, can make a big difference to a driver's lifestyle.

Informing the DVLA of those who have the condition, particularly those who have to use insulin as treatment, is paramount to remaining compliant and can be done quickly online with the links that I have posted in this blog.

Drivers with diabetes are not always prevented from driving and we've seen that if certain requirements - such as visual tests – are met then the condition needn't be a barrier to driving a vehicle. Insurance cover from QBE works on much the same basis; if we are satisfied that the various requirements with the DVLA have been met then cover is provided often without an increase in premiums and other terms and conditions.

It's important however that sectors of the transport industry continue to work together by collaborating; by sharing concerns, feedback and advice. Insurers are now providing E-learning risk-management tools and specialist seminars on motor-risk management as part of their cover, affirming the importance of collaboration between insurer and customer also. At QBE we can provide help and advice via our Risk Solutions team or within guidance literature.

Ultimately, all of this boils down to the same goal: Making the roads safer.

For further information on diabetes in the work place download QBE’s Diabetes and the workplace report

References

https://diabetes.co.uk/diabetes-prevalence.html

Further information

www.diabetes.co.uk

www.diabetes.org.uk/Guide-to-diabetes/Life-with-diabetes/Driving

www.gov.uk/diabetes-driving