Individuals with diabetes may drive an automobile, if they take certain precautions and comply with the special requirements of their disease.

General precautions

Individuals with diabetes who have a driver’s license must:

Have regular checkups by a physician (to assess potential diabetes complications and blood glucose (sugar) control);
Have a good understanding of their disease and follow the recommendations of health care professionals;
Take certain precautions when driving (primarily people at risk of hypoglycemia).

Precautions for individuals being treated with insulin or an insulin secretagogue*

You must measure your blood glucose (sugar) levels before taking the wheel, then every 4 hours thereafter on long trips. Your blood glucose (sugar) levels should be:

Above 4 mmol/L if you are driving a car or motorcycle
Above 6 mmol/L if you are driving a vehicle other than a car or motorcycle (classes 1, 2, 3, 4)

If you have ever had severe hypoglycemia or hypoglycemic episodes with no warning signs, caution is advised. You should measure your blood glucose (sugar) levels before you depart and every hour thereafter. In this case, your blood glucose (sugar) level should be above 6 mmol/L before taking the wheel of a car or motorcycle.

*Gliclazide (Diamicron^® and Diamicron MR^®), Glimepiride (Amaryl^®), Glyburide (Diabeta^®, Euglucon^®), Repaglinide (GlucoNorm^®).

What you should do in the case of hypoglycemia

e sure that you always carry sources of rapidly absorbed carbohydrates.

If you feel the signs of hypoglycemia while you are driving:

Stop.
Take a blood glucose (sugar) reading.
If it is below 4 mmol/L, treat the hypoglycemia.

You should wait 45 minutes before taking the wheel again. This is the delay necessary to return to normal vigilance.

If it’s impossible for you to measure your blood glucose (sugar) level but you feel the symptoms of impending hypoglycemia, don’t take a chance. Eat some carbohydrates.

Responsibilities of drivers to the SAAQ

Driving a vehicle is a privilege, not a right. Thus, a licensed driver is required to inform the SAAQ of any change to his/her physical or mental condition.

To reduce the risk of accidents, the Société de l’assurance automobile du Québec (SAAQ ) must ensure that drivers have the necessary physical and mental capabilities to safely operate a motor vehicle. Obviously, the SAAQ cannot conduct a complete health examination of every licensed driver in the Province of Québec. Consequently, it must rely on a declaration from the driver or a health care professional, or the results of a medical checkup, for the health status of every Québec driver.

Mandatory Driver Declaration

Driving a vehicle is a privilege, not a right. Thus, a licensed driver is required to inform the SAAQ of any change to his/her physical or mental condition when first applying for a driver’s license, when renewing the license, and within 30 days following a change in his/her health status.

Driving and diabetes (take the test)

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What type of vehicle do you drive?(Required)

Private (classes 5,6)

Commercial (classes 1,2,3,4)

Recommendations

Your treatment for diabetes involves no (or little) risk of hypoglycaemia.

You still need to make sure you:

Declare your state of health to the SAAQ;
Pass a medical examination at least every 2 years;
Avoid driving if you experience symptoms of high blood sugar that could affect your ability to drive (e.g. difficulty concentrating, drowsiness, blurred vision).

Your oral antihyperglycemic medication increases your risk of hypoglycemia.

Hypoglycemia may present with symptoms that compromise driving ability (e.g. tremors, headaches, dizziness, weakness, impaired vision). When left untreated, hypoglycemia can lead to loss of consciousness.

This is why it is important to play an active role in the prevention of hypoglycaemia while driving, for your safety and that of other road users.

You must ensure that:

Declare your state of health to the SAAQ;
Pass a medical examination at least every 2 years;
Know how to prevent, recognize and treat hypoglycaemia;
Have a blood glucose meter or continuous glucose monitoring system and fast-absorbing carbohydrates on hand at all times while on the road;
Test your blood sugar before driving, at least every 4 hours on the road and if you experience symptoms of hypoglycemia:
- If the result is less than 4.0 mmol/L:stop the vehicle and treat hypoglycemia without delay.It is suggested to wait 40 minutes before driving after ensuring that blood sugar is above 5.0 mmol/L. This ensures a return to normal alertness and decreases the risk of having another episode of hypoglycaemia.
- If the result indicates hyperglycemia and you experience symptoms that could affect your ability to drive (e.g. difficulty concentrating, drowsiness, blurred vision): stop the vehicle and take the necessary measures to ensure safe driving.

Taking insulin increases your risk of hypoglycemia.

This is why it is important to play an active role in the prevention of hypoglycaemia while driving, for your safety and that of other road users.

You must ensure that:

Declare your state of health to the SAAQ;
Pass a medical examination at least every 2 years;
Know how to prevent, recognize and treat hypoglycaemia;
Have a blood glucose meter or continuous glucose monitoring system and fast-absorbing carbohydrates on hand at all times while on the road;
Test your blood sugar before driving, at least every 4 hours on the road and if you experience symptoms of hypoglycemia:
- If the result is less than 4.0 mmol/L: stop the vehicle and treat hypoglycemia without delay. It is suggested to wait 40 minutes before driving after ensuring that blood sugar is above 5.0 mmol/L. This ensures a return to normal alertness and decreases the risk of having another episode of hypoglycaemia.
- If the result indicates hyperglycemia and you experience symptoms that could affect your ability to drive (e.g. difficulty concentrating, drowsiness, blurred vision): stop the vehicle and take the necessary measures to ensure safe driving.

Your treatment for diabetes involves no (or little) risk of hypoglycaemia. You can, in principle, drive any type of vehicle, provided you have regular medical monitoring.

You still need to make sure you:

Declare your state of health to the SAAQ;
Pass a medical examination when applying for a business license and at least every 2 years thereafter;
Have a comprehensive eye exam by an optometrist or ophthalmologist when applying for a business license and annually thereafter (or as the frequency recommended by the professional);
Avoid driving if you experience symptoms of high blood sugar that could affect your ability to drive (e.g. difficulty concentrating, drowsiness, blurred vision).

The commercial license could be refused or withdrawn in the event of:

Visual ability at a level below the standards set by the SAAQ;
Neuropathy, amputation or cardiovascular disease that prevents safe driving.

A person who does not submit to medical examinations at least every 2 years could also have their business license revoked.

Your oral antihyperglycemic medication increases your risk of hypoglycemia and you drive a commercial vehicle.

This is why it is important to play an active role in the prevention of hypoglycaemia while driving, for your safety and that of other road users.

You must ensure that:

Pass a medical examination when applying for a business license and at least every 2 years thereafter;
- This review should include an assessment of the risk of hypoglycaemia based on the nature of the job, work schedules, type of vehicle driven, recognition of symptoms of hypoglycaemia, ability to treat hypoglycaemia as well as frequency and severity of hypoglycaemia in the past year.
Have a comprehensive eye exam by an optometrist or ophthalmologist when applying for a business license and annually thereafter (or as the frequency recommended by the professional);
Know how to prevent, recognize and treat hypoglycaemia;
Have a blood glucose meter or continuous glucose monitoring system and fast-absorbing carbohydrates on hand at all times while on the road;
Test your blood sugar before driving, at least every 4 hours on the road and if you experience symptoms of hypoglycemia:
- If the result is less than 4.0 mmol/L: stop the vehicle and treat hypoglycemia without delay. It is suggested to wait 40 minutes before driving after ensuring that blood sugar is above 5.0 mmol/L. This ensures a return to normal alertness and decreases the risk of having another episode of hypoglycaemia.
- If the result indicates hyperglycemia and you experience symptoms that could affect your ability to drive (e.g. difficulty concentrating, drowsiness, blurred vision): stop the vehicle and take the necessary measures to ensure safe driving.

The commercial license could be refused or withdrawn in the event of:

Visual ability at a level below the standards set by the SAAQ;
Neuropathy, amputation or cardiovascular disease that prevents safe driving;
Insufficient knowledge of the causes, symptoms and treatment of hypoglycaemia.

A person who does not submit to medical examinations at least every 2 years could also have their business license revoked.

Taking insulin increases your risk of hypoglycemia and you drive a commercial vehicle.

This is why it is important to play an active role in the prevention of hypoglycaemia while driving, for your safety and that of other road users.

You must ensure that:

Pass a medical examination when applying for a business license and at least every 2 years thereafter;
- This review should include an assessment of the risk of hypoglycaemia based on the nature of the job, work schedules, type of vehicle driven, recognition of symptoms of hypoglycaemia, ability to treat hypoglycaemia as well as frequency and severity of hypoglycaemia in the past year.
Have a comprehensive eye exam by an optometrist or ophthalmologist when applying for a business license and annually thereafter;
Know how to prevent, recognize and treat hypoglycaemia;
Have a blood glucose meter or continuous glucose monitoring system and fast-absorbing carbohydrates on hand at all times while on the road;
Test your blood sugar before driving, at least every 4 hours on the road and if you experience symptoms of hypoglycemia:
- If the result is less than 4.0 mmol/L: stop the vehicle and treat hypoglycemia without delay. It is suggested to wait 40 minutes before driving after ensuring that blood sugar is above 5.0 mmol/L. This ensures a return to normal alertness and decreases the risk of having another episode of hypoglycaemia.
- If the result indicates hyperglycemia and you experience symptoms that could affect your ability to drive (e.g. difficulty concentrating, drowsiness, blurred vision): stop the vehicle and take the necessary measures to ensure safe driving.

The commercial license could be refused or withdrawn in the event of:

Visual ability at a level below the standards set by the SAAQ;
Neuropathy, amputation or cardiovascular disease that prevents safe driving;
Insufficient knowledge of the causes, symptoms and treatment of hypoglycaemia.

A person who does not submit to medical examinations at least every 2 years could also have their business license revoked.

You mentioned having had severe hypoglycaemia (requiring the help of another person to treat or with loss of consciousness).

You must make sure to notify the SAAQ within 30 days of the episode.

This could result in the temporary withdrawal of the license.

You should also measure your blood sugar every 2 hours on the road or wear a continuous glucose monitoring system.

You mentioned no longer feeling the warning symptoms of hypoglycemia. It is important to discuss this with your doctor. He or she will be able to make a complete assessment of the risk involved in driving and the measures to be taken.

This could result in the temporary withdrawal of the license.

You have one or more diabetes complications that affect your ability to drive.

You must therefore also ensure that:

Inform the SAAQ of your condition within 30 days of diagnosis of the complication;
Have regular medical follow-up.

If your driver’s license has been suspended following an episode of severe hypoglycemia or the absence of warning symptoms in the event of hypoglycemia, you can recover it from the SAAQ if:

You have not had severe hypoglycaemia in the past 6 months;
You have had symptoms of low blood sugar for at least 6 months.

If your driver’s license was temporarily withdrawn following an episode of severe hypoglycemia or the absence of warning symptoms in the event of hypoglycemia, you can recover it from the SAAQ if:

You have not had severe hypoglycaemia in the past 12 months;
You have had symptoms of low blood sugar for at least 12 months.

You will also need to measure your blood sugar every 2 hours on the road or wear a continuous glucose monitoring system.

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For more specific information about diabetes and driving, see:

Medical Assessment of Drivers, on the web site of the Société de l’assurance automobile du Québec.
Regulation respecting access to driving a road vehicle in connection with the health of drivers Refer to DIVISION IX: ILLNESSES AND DEFICIENCIES AFFECTING METABOLISM.
To contact the Société de l’assurance automobile du Québec about the medical assessment of drivers, call:
- (418) 643-5506 (Québec City calling area)
- 1-800-561-2858 (toll-free)

Thank you to the Société de l’assurance automobile du Québec for their collaboration.

Driving and diabetes

General precautions

Precautions for individuals being treated with insulin or an insulin secretagogue*

What you should do in the case of hypoglycemia

Responsibilities of drivers to the SAAQ

Driving and diabetes (take the test)

Recommendations

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