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prevostman
07-06-2008, 03:12 PM
Driving a Coach: Drivers and Diabetes

In recognition of recent advances in medical technology, namely accurate, portable blood monitors (glucometers) and insulin pumps, the U. S. Department of Transportation (DOT) has decided that for the first time, that insulin-dependent drivers can obtain a Commercial Driver's License (CDL). This is a first step toward recognizing that people who have diabetes are capable and able operators of large vehicles on the roadway.

For the private coach owner with diabetes, it should provide encouragement that with proper testing and glucose monitoring, driving should not be considered to be any different activity than those who do not suffer from diabetes.

Here's the history: In 1970, a blanket policy was adopted which banned people with diabetes from obtaining a CDL. Further, this could have implied that even a private coach owner with diabetes may have increased liability if found at fault in an accident. This early policy was based on the idea that insulin-dependent people had a higher rate of being involved in an accident than the general population. Since that blanket ruling, many studies were conducted to determine if that was indeed the case. In 2003, an intensive study was undertaken which found that individuals would be granted a CDL on a case-by-case basis. Every three years, drivers with diabetes have to show that they have been accident-free in order to renew their licenses.

So, if you or another person in your family has diabetes, here are some tips for safe operation of a private coach which may be helpful.

1. Whether the driver is insulin-dependent or not, check blood sugars before driving. Normally, blood sugars in the 70-120 ml/dl are considered normal.

2. Have good, high quality snacks on hand for your driver. No sense in creating a road emergency when none should exist.

3. Get plenty of rest before driving. For some people, driving, especially driving on an infrequent basis, can be stressful, creating either higher or lower blood sugars.

4. Be aware that, if involved in an accident, it may come to light that your driver has diabetes and lawsuits being what they are, the issue of having diabetes may come to the fore. Make sure that you have taken all appropriate precautions before any questions may be asked.

5. Low blood sugars are the most troublesome as many people are not aware they are having low blood sugar. There have been cases of police not noting diabetes identification actually arresting and locking up people with diabetes as DUI suspects when they are experiencing a hypo-glycemic episode. Low blood sugar and driving a private coach do not go together.

6. Keep your driver company (which is a good thing to do anyway) and if there are any signs of blood sugar problems, work together to get off the road and to a safe location as efficiently as possible.

7. Many private coach owners are, well, not in their early years and we all have various limitations, such as glasses, other medications or perhaps diabetes as well, and it's better to be safe on the road rather than trying to explain away the lack of taking precautions before getting on the highway.

bridgestohealth
07-14-2008, 12:54 AM
I would like to comment on your diabetes article. CDL's are usually given to truck-drivers and not to owners of RVs. I know this because I have a family member who drives an 18-wheeler for a living, and he also has diabetes. He takes oral medication right now, however if he ends up going on insulin injections he will lose his CDL license.

Also, I am not sure where you are getting your data about RV drivers and diabetes but there are several studies that conclude the opposite. One such study, done by Stork, Haeften, and Veneman* concluded that there was no evidence that older drivers with diabetes are a greater risk for accidents.

Also,you mentioned that a normal blood sugar is between 70-120, that is correct, but not if you are a diabetic. Diabetic normal blood sugar levels are higher because a diabetic, even with medication is not going to be able to maintain a blood sugar between 70-120.

Diabetics should eat several small meals a day and blood sugars should be checked before each meal or as directed by their physician. To help maintain adequate blood sugars diabetics should:

1. Increase activity - the more active you are the more blood sugar you will burn.
2. Eat 5 small meals a day consisting of natural whole foods. Stay away from foods that are processed, fried, added salt and sugar, to name a few.
3. Don't eat (or limit) what you can live without, that means: cakes, candy, soda pop, ice-cream, cookies, and the like.
4. Reduce stress: stress increases cortisol production in the adrenal glands, a hormone that increases blood sugar and causes havoc to many body systems.
5. Laugh: It reduces stress, lowers blood pressure, increases production of good hormones and well, just makes you feel darn good.
6. Get plenty of rest and if you are tired take a power nap during the day.



I think it is great that the Internet provides us an avenue to share our thoughts on a variety of topics - just don't take everything you read as gospel. Check it out - get the facts - and make your own decisions. Armed with knowledge you will make better health related choices.

In health and wellness,

Dr. Linda Mundorff


*A. D.M. Stork, T. W. van Haeften, and T. F. Veneman
Diabetes and Driving: Desired data, research methods and their pitfalls, current knowledge, and future research
Diabetes Care, August 1, 2006; 29(8): 1942 - 1949.