The NDSS is administered by Diabetes Australia

Diabetes essentials

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.

 

Diabetes and driving

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.

Driver licensing authorities

For more information, refer to your local licensing agency for specific guidelines and the national guidelines for driving:

Find out more
ndss-hypo-driving

Hypos and 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.

How to reduce the risks of having a hypo while driving

  • Before you get in the car, check your blood glucose level. It needs to be above 5 mmol/L and stable before you drive.
  • Carry a blood glucose meter with you when you drive. Do this so you can confirm your blood glucose level even if you use a continuous glucose monitoring (CGM) or flash glucose monitoring (Flash GM) device to manage your diabetes.
  • Carry fast-acting and longer-acting carbohydrate (carb) foods (or drinks) with you. Keep extra supplies in your vehicle.

Why the caution about driving and type 1 diabetes?

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.

Top tips

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.

Find out more

Don't drive under 5

What do you do if you have a hypo while driving

Pull the car over to the side of the road.

Turn off the engine and remove the keys.

Check your blood 
glucose level.

Treat the low blood glucose.

Wait 30 min and check your blood glucose level again.

Take breaks and check your blood glucose every two hours on long trips.

Treating low blood glucose

  1. If below 5 mmol/L, drink or eat 15 grams (g) of fast-acting carbohydrates (carbs).
  2. Wait 15 minutes and check your blood glucose level again. If still below 5 mmol/L, eat or drink another 15 g of fast-acting carbs.

  3. Once your blood glucose level is above 5 mmol/L, eat 15 g of long-acting carbs such as a banana, a slice of whole grain bread or a muesli bar.

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.

Severe hypo

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.

Reduced awareness of hypos

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.

Top tip

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.

Driving safely

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 and driving

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.

There are some regular checkups you can have to keep yourself and others safe on the road:

Hypo kit​

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.​

Pathology blood test

Have your HbA1c checked regularly.

Feet

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.

Eyes

Have your eyes checked every 12 months or more often as recommended by your doctor.

Blood glucose meter

Check the accuracy of your blood glucose meter regularly. Your diabetes educator or pharmacist can help you.

CGM or Flash GM device

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.

Diabetes in the workplace

Diabetes and employment

You’ll probably have questions about your employment when you have type 1 diabetes, such as:

  • How do I manage diabetes at work?
  • Should I disclose my diabetes to my employer?
  • What if my job requires me to drive?
  • Do l have to disclose my diabetes to my superannuation fund or insurance company?
  • Do l have a right to reasonable adjustments at the workplace?

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.

Talking to my employer

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.

Your rights at work

Employers are obliged to make reasonable adjustments so people with diabetes can work safely. These include:

  • Keeping your medical condition confidential.
  • Being flexible with breaks, meeting times, medical appointments and shifts.
  • Allowing regular breaks so you can have meals and snacks as needed.
  • Setting aside a private and clean place to check blood glucose levels and take insulin.
  • Providing a first aid kit.
  • Making available a sharps disposal container for the safe disposal of lancets (finger pricking needles), syringes and insulin pen needles, CGM and Flash GM sensors and insulin pump cannulas.
  • Providing an enlarged computer screen for those with impaired vision.

The federal government provides funds for employers to help with costs for eligible workplace adjustments under the Employment Assistance Fund.

Workplace discrimination

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.

Diabetes and travel

Preparing for travel

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.

What to ask before you travel

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.

Find out more

What to pack

Travelling by air

It’s essential to prepare for air travel when you have type 1 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.

Air travel tips

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.

Travel support

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.

Find out more
  • Go to smartraveller for the latest information and advice to stay safe overseas.
  • Go to Medicine and substances on the Australian Border Force website for what to keep in mind, when entering and leaving Australia.

Travel prep

Talk to your diabetes health professionals before you travel, to organise the following:

  • a letter from your doctor about your health and which medications and diabetes supplies you need to carry with you for your diabetes
  • prescription for medications including insulin and glucagon, and consider medication for nausea and diarrhoea if traveling overseas
  • written plans to manage any diabetes issues on the trip, for example, hypo and illness (sick days)
  • a list of contact details (phone number and/or email) for your doctor and diabetes health professionals
  • a written plan for how to manage your diabetes, including insulin and eating, if you are travelling across time zones.

Take out travel insurance and health cover including for having type 1 diabetes.

Pack a diabetes travel kit

Organise extra supplies like:

  • insulin and injection device(s)
  • medication for nausea and diarrhoea if travelling overseas
  • glucose and ketone checking strips
  • blood glucose meter
  • extra glucose sensors and transmitters if using a CGM or Flash GM device
  • extra consumables if using an insulin pump
  • healthy snacks (it’s always good to have more than you think you’ll need) and a hypo kit and sick day action kit.

Bring your essentials such as insulin, glucagon, hypo and sick day action kit in your carry-on luggage when travelling by plane.

Travel tips for insulin pump users

  • Know how to convert your settings to insulin injections in case your pump fails.
  • Pack back-up equipment for insulin injections.
  • Have a copy of your pump settings for easy reference.
  • Ask your insulin pump company about borrowing a spare one for your trip.

While you’re travelling

Carry-on luggage

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.

Packing

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.

Carry identification

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 regularly

Check your blood glucose levels often while you’re travelling to make sure they stay in your target range.

Have your diabetes supplies within reach

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.

Stay hydrated

Drink plenty of water while travelling. Staying hydrated is important for keeping blood glucose levels in check.

Travel tips for insulin pump users

Airport Security

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.

Time Zones

Keep track of both of your departure and destination time zones. Adjust your insulin pump’s time settings to the local time upon arrival.

At your travel destination

Changes in routine, time zones, or food can affect your blood glucose levels

Remember to check your blood glucose more frequently while travelling. Pack some healthy snacks and include physical activity.

Check your blood glucose levels regularly

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.

Know your emergency contacts

Be prepared by knowing how to contact:

  • emergency services in the country you’re visiting, just in case
  • your diabetes health professionals at home
  • your travel insurance company Australian Government to get help if you are concerned about your welfare when overseas.