Driving and insulin--consensus, conflict or confusion?
OBJECTIVE
All drivers requiring insulin treatment must be able to demonstrate satisfactory diabetic control and recognition of hypoglycaemic symptoms before being allowed to drive a motor vehicle. Clinicians have a duty to discuss fitness to drive with their patients. However, is the advice given consistent and in line with the regulations published by the Driver and Vehicle Licensing Authority (DVLA)?


METHODS
Six 'real-life' case scenarios were posted to clinicians (consultant diabetologists, specialist registrars and diabetes specialist nurses) within Wessex, UK. The identical cases were also sent to the DVLA for their comments.


RESULTS
Sixty-six doctors (36 consultants) and 70 diabetes specialist nurses were contacted by postal questionnaire of which replies were received from 17 consultants (47%), 17 specialist registrars (57%) and 39 diabetes specialist nurses (56%). Although there was general agreement in cases of hypoglycaemia unawareness, there was disagreement where patients had or were at risk of unstable control albeit for a short time.


CONCLUSIONS
Patients treated with insulin may receive conflicting information concerning their ability to drive.
Flanagan
D E
DE
Bournemouth Diabetes and Endocrine Centre, UK.
Watson
J
J
Everett
J
J
Cavan
D
D
Kerr
D
D
D000293:Adolescent; D001334:Automobile Driving / Q000331:legislation & jurisprudence; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007003:Hypoglycemia; D007328:Insulin / Q000627:therapeutic use*; D008004:Licensure / Q000331:legislation & jurisprudence*; D008297:Male; D008875:Middle Aged; D009049:Motorcycles / Q000331:legislation & jurisprudence; D009726:Nurses; D010820:Physicians; D011247:Pregnancy; D011254:Pregnancy in Diabetics; D011795:Surveys and Questionnaires; D006113:United Kingdom
D007328:Insulin