Diabetes and driving: risks awareness

September 7

Collecting activity data from smartphones and gadgets allows us to better understand the impact of specific behaviors on health, and therefore adjust them for better results and wellbeing. We track various activities and we do that, not only because gadgets allow us, but because each activity has its own effect on the level of blood glucose. By determining patterns of these activities, we can better understand the events that lead to hypo- and hyperglycemia, which are vital to help people with diabetes avoid. We want to describe every activity that we are passively capturing and explain the reason why these can be useful. Today, we’d like to start with driving.

Driving is classified as a low-intensity activity, but it can be associated with a high level of stress. This activity is not so obvious at first glance, as movement-wise it’s rather passive; however, with driving, there is more than meets the eye. Studies held with a driving simulator showed that driving requires many demanding situations and decision-making scenarios that are significant stressors to the driver. These stressors are associated with greater autonomic symptoms and higher glucose levels are needed to manage them

Even short driving trips can sometimes lead to hypoglycemia or hyperglycemia, both of which can cause very dangerous situations. It is important to know the symptoms, but the biggest problem is that it can be difficult for people to distinguish them. The symptoms of hypoglycemia while driving may be the following:

  • Staying in lane and making decisions takes more concentration
  • Finding it more difficult to focus your eyes
  • Changes in body temperature – having a warm flush or suddenly feeling cold
  • Fatigue and/or hunger
  • Feeling a tingling sensation, particularly in your fingers, lips or tongue
  • A rise in your heartbeat
  • Stronger emotions than usual, such as angry, frustrated, worried, confused

Every single symptom listed is exceptionally dangerous while driving. Early prevention and awareness can save the lives of both the person with diabetes, people in surrounding vehicles, and people outside on the street. The most common advice found online is to consider the possibility of hypoglycemia if you notice any change in how you’re feeling or if you’re unable to concentrate. However, the best thing to do is to be aware of the possibility and prevent it, instead of treating it when it has already happened. It is not just the changes in metabolism that are dangerous, but the failure to understand that driving a car can lead to these changes.

Another serious case is the condition called “hypoglycemia unawareness” that occurs when low blood glucose happens rapidly and doesn’t reveal any symptoms beforehand. It causes extra danger and needs to be treated with a professional in order for a person with the condition to learn how to feel a hypo coming.

Understanding the risk and being aware of the possible hypo- cases sounds like an easy task, but unfortunately, studies have demonstrated that most people living with diabetes don’t know about this and have not even thought about it.

Hypoglycemia is only relevant to people who are treated with insulin. Therefore, it is important to provide information when starting insulin therapy. Unfortunately, this information is usually not given, as it is often done by general practitioners. An insulin-treated person should always measure their blood sugar before driving. This means that they also have the legal right to act responsibly in road traffic. The German Diabetes Society gives guidelines that blood sugar should possibly be higher than 120mg / dL before starting the journey.

Of course, for most people with diabetes driving is a rather safe activity, but precaution is never a bad idea. We were very surprised to find out that a Scottish study showed that only 62% of health care professionals suggested that insulin-treated drivers should test their blood glucose before driving; 13% of health care professionals thought it was safe to drive with blood glucose <72 mg/dL (4 mmol/L), and 8% did not know that impaired awareness of hypoglycemia might be a contraindication to driving.

There are even professionals who are not aware of this and therefore do not communicate the possible hypoglycemia risks to their patients. So nearly half of drivers with type 1 diabetes and three-quarters of those with type 2 diabetes had never discussed driving guidelines with their physician.

Driving can be detected by wearables and smartphones, and can be distinguished from other transportation methods. Detection of the activity and the correlation between blood glucose level depending on the duration of the trip brings us patterns and regularities that can allow us to make conclusions about the effect on each individual. As a result, we hope to make driving a safer activity and to make patients’ lives a bit easier.

All the suggestions in this article are presented for general information and should not be perceived as a medical advice. You should always consult your healthcare professional when making any changes in your activity, medication, or diet.


Cox DJ, Gonder-Frederick LA, Kovatchev BP, Clarke WL. The metabolic demands of driving for drivers with type 1 diabetes mellitus. Diabetes Metab Res Rev. 2002

Watson WA, Currie T, Lemon JS, Gold AE. Driving and insulin-treated diabetes: who knows the rules and recommendations? Pract Diabetes Int 2004

American Diabetes Association. Diabetes and driving. Diabetes Care Volume 37, Supplement 1, January 2014

Harsch IA, Stocker S, Radespiel-Troger M, et al. Traffic hypoglycaemias and accidents in patients with diabetes mellitus treated with different antidiabetic regimens. J Intern Med 2002

This project is co-financed via the European Regional Development Fund (ERDF)