As a person with type 1 diabetes, you’re no different from any other person living in Australia. Diabetes will make some aspects of life more challenging, but it shouldn’t define who you are or stop you from enjoying life. If you’re planning an overseas holiday or getting your driver’s licence, there’s important information you need to know to manage your diabetes well in some situations.
You can still drive if you have type 1 diabetes, you just need to manage it well and be prepared.
Driving is a complex skill, both physically and mentally. And if you have type 1 diabetes, you may need to take extra precautions to ensure road safety.
When taking insulin, the main risk to your safety is having hypoglycaemia (a hypo) where blood glucose levels drop too low. A hypo is usually a blood glucose level below 4 mmol/L. But symptoms can sometimes happen when blood glucose levels are a little above or below 4 mmol/L. Having diabetes-related complications like eye or foot problems can also affect your ability to drive safely.
You can get a licence to drive a private or commercial vehicle but you’ll need to tell the driver licensing authority in your state or territory. It’s a legal obligation. They will ask for a medical report which you can get from your diabetes doctor.
Although there are national Fitness to drive guidelines, all states and territories have slightly different regulations for assessment of fitness to drive. The guidelines attempt to balance the safety of all road users and any unfairness against people with type 1 diabetes.
If you’re diagnosed with diabetes, you should inform your vehicle insurer to prevent problems with insurance claims.
For more information, refer to your local licensing agency for specific guidelines and the national guidelines for driving:
It’s not safe to drive when you have a hypo. It’s important to check your blood glucose level before driving.
A hypo can happen quickly once your blood glucose level is under 5 mmol/L. Early warning symptoms of a hypo are trembling, light headedness, hunger and headache.
In addition to the risks from having a hypo, people with type 1 diabetes are also at risk from driving with high blood glucose levels (hyperglycaemia). Hyperglycaemia can cause blurry vision, make you tired and cause poor concentration. Other symptoms include numb or tingling feet. These symptoms can impact your reaction time when driving.
It’s a good idea to wear or carry identification showing that you have type 1 diabetes.
Talk to your diabetes health professionals about how to reduce your risk of hypos while driving.
DO NOT resume driving until your hypo symptoms have completely gone and your blood glucose level has remained above 5 mmol/L for at least 30 minutes. Even if you are feeling better, wait for 30 minutes, as studies have shown that your brain function may take this long to fully recover.
A severe hypo is where you need help from others to treat it or where you’ve lost consciousness or had a seizure.
If you’ve experienced a severe hypo, it’s essential you don’t drive again until you have medical clearance to do so. The general recommendation is to wait for a minimum of six weeks before getting back behind the wheel. Your diabetes specialist will determine your fitness to safely resume driving.
Some people with diabetes find it hard to know or feel the early symptoms of a hypo. This is called reduced awareness of hypoglycaemia or hypo unawareness. This is a serious condition that increases the risk of having a severe hypo. If a mild hypo isn’t recognised and properly treated, blood glucose levels may drop to the point where brain function is affected, without any warning.
A hypo can happen quickly. But those with hypo awareness will get early warning symptoms such as trembling, sweating, lightheadedness, hunger, headache, rapid heart rate and tingling around the mouth, lips and cheeks. This alerts them to the need to eat. If not treated at this stage, blood glucose levels will drop further. This reduces the glucose supply to the brain, causing poor concentration, behavioural changes, irritability, changes in vision and a reduced level of consciousness.
People with reduced awareness of hypos lose the early warning symptoms. They may have few or no symptoms, even when the blood glucose is very low. As a result, they can become confused and even lose consciousness. This can happen without them even knowing their blood glucose levels are low and dropping.
If you don’t experience the usual symptoms of hypos, or your hypo symptoms have lessened, ask your diabetes health professionals for advice about how to reduce your risk of potential harm or injury.
Diabetes-related complications may affect your ability to drive safely. Some examples are trouble feeling the pedals due to nerve damage in your feet (peripheral neuropathy) and changes to your vision due to eye disease (diabetic retinopathy). Talk with your doctor about the possible effects on your ability to drive safely.
Hyperglycaemia can result in tiredness, blurry vision and altered decision-making. All of which impact on driving. If you feel unwell and your blood glucose level is high, it’s important not to drive.
Carry your blood glucose meter, strips and hypo kit with you. Don’t leave the kit in the car. The heat and light will damage the strips.
Have your HbA1c checked regularly.
Have your feet checked at least every 12 months or more often as recommended by your doctor. Seek advice from your doctor or podiatrist straight away if your feet or legs are numb or painful, or you have trouble feeling the pedals when you drive.
Have your eyes checked every 12 months or more often as recommended by your doctor.
Check the accuracy of your blood glucose meter regularly. Your diabetes educator or pharmacist can help you.
Check your blood glucose level before and during driving with a blood glucose meter. Remember, due to “lag time”, using a CGM or Flash GM device will show a higher level when blood glucose levels are dropping fast.
You’ll probably have questions about your employment when you have type 1 diabetes, such as:
Discuss your work situation with your diabetes health professionals. They will be able to give you advice on how to manage your diabetes while at work.
Go to the Diabetes Australia website for more information about your rights in the workplace:
Most people with diabetes have fulfilling and productive careers until retirement. But if you face difficulties at any stage of your working life know you’re not alone. There are many organisations that can support you.
You don’t need to tell your employer you have diabetes unless you’re working in a safety sensitive job such as the police force, defence, ambulance services, transport vehicle.
But it might give you peace of mind to tell your employer and co-workers so they can support you if needed. For example, so they understand you need to take regular meal breaks or help you treat a hypo.
If you’re having difficulties in the workplace, speak to a manager or employee representative in the first instance. But if the issue isn’t resolved you can contact your state or territory diabetes organisation, or check out information for employees from Fair Work.
Employers are obliged to make reasonable adjustments so people with diabetes can work safely. These include:
The federal government provides funds for employers to help with costs for eligible workplace adjustments under the Employment Assistance Fund.
Know your rights to avoid discrimination when applying for a job or while in your current job. You can do this by talking to staff at your state or territory equal opportunity and human rights commission, your union delegate or professional association.
There are laws in Australia so that a medical condition can’t be used as unfair grounds for refusing you a job or promotion, or for dismissal.
If you face discrimination, speak to a manager or employee representative. If the complaint isn’t resolved then go to Diabetes Australia website for contact details to your state or territory discrimination body.
Careful planning before travelling is very important when you have type 1 diabetes. You need to think about several things before you travel to make sure you can enjoy yourself and stay healthy.
Having type 1 diabetes means you’ll need to think about your diabetes management and general health. As well as available foods, consider special requirements you’ll need during the trip and at the destination, what to pack and travel insurance.
As part of your travel planning, talk to your diabetes health professionals well ahead of your trip. This will make sure you have enough time to get any vaccinations you may need. It’ll also give you time to get prescriptions filled for your insulin and any other medication you’re taking. It’s also important to talk about managing air travel and what to do if something goes wrong.
Check your travel insurance is right for you and if you have to list preexisting conditions such as diabetes.
Talk to your diabetes health professionals at least three months before you plan to fly. Make sure you follow airline security regulations for your medication and equipment.
Ask security staff to physically check you and your luggage rather than using the X-ray equipment. Insulin pumps and CGM transmitters can be damaged by x-rays in security equipment.
During the flight keep your supplies within easy reach. Ask for extra carbs if you need to. Remember to drink water to stay hydrated. Get as much sleep as you can and ask to be woken for meals.
Wear comfortable shoes. Exercise your feet to help prevent swelling. It’ll also help keep your blood glucose levels within your target range.
If you use an insulin pump or a CGM and Flash GM device, talk to your diabetes health professionals about managing these devices during plane travel.
Careful planning reduces the risk of things going wrong. If something does go wrong, don’t panic. Seek medical assistance if needed, ideally with advice from your travel insurer.
If you’re travelling overseas, consider registering your travel plans with the Department of Foreign Affairs and Trade. They can then contact you or your family in the event of an emergency.
Take out travel insurance and health cover including for having type 1 diabetes.
Bring your essentials such as insulin, glucagon, hypo and sick day action kit in your carry-on luggage when travelling by plane.
Keep essential diabetes items in your carry-on when travelling by plane. This includes your insulin and glucose monitoring equipment, and your hypo and sick days action plan.
Pack your diabetes supplies in your carry-on bag instead of your checked bags if you’re flying. This way, you’ll have everything you need, even if your checked bags get lost. It’ll also stop your diabetes supplies from being exposed to big temperature changes, which can stop your insulin from working.
Wearing a medical ID bracelet and carrying your doctor’s letter can help others understand your diabetes in case of an emergency.
If you have a smartphone, use the “In Case of Emergency app” to provide medical information even when the phone is locked.
Check your blood glucose levels often while you’re travelling to make sure they stay in your target range.
Store your diabetes supplies, including your hypo kit within arm’s reach, such as under the seat in front of you if you are traveling by plane. This way you’ll have snacks and supplies on-hand should you have a hypo or if there is a delay in getting meals.
Drink plenty of water while travelling. Staying hydrated is important for keeping blood glucose levels in check.
Don’t remove your insulin pump or CGM or Flash GM device during security checks. Declare your device at the security checkpoint and show your doctor’s letter. Inform security staff that your device must not be exposed to X-rays.
Keep track of both of your departure and destination time zones. Adjust your insulin pump’s time settings to the local time upon arrival.
Remember to check your blood glucose more frequently while travelling. Pack some healthy snacks and include physical activity.
Pack your favourite healthy snacks for when you’re on the go and sightseeing. This will help you avoid unhealthy choices and manage your blood glucose levels.
Make sure you stay hydrated, especially when active or in hot weather.
Be prepared by knowing how to contact:
Go to Smart Traveller.