In the Spotlight: Driving With Type 1 Diabetes

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When a teen with type 1 diabetes is training to get his or her license, learning safe driving involves more than just pointers on parallel parking or correctly using turn signals. Managing blood sugar while behind the wheel is a serious safety issue for both the driver him- or herself and everyone else on the road.  

Is your teen ready to combine the responsibilities of good diabetes management with operating a motor vehicle? Your diabetes care team can help you with this question, as well as offer guidance on precautions to take. It’s a big step for parents to hand over the keys, but with type 1 in the mix, it can seem more like a giant leap. Check out these road-tested tips to help your child make the transition to the driver’s seat.   

A Different Kind of Driver’s Test

Jaclyn A. Shepard, Psy.D., is a licensed pediatric psychologist and assistant professor at the University of Virginia School of Medicine. In addition to working with families and children coping with type 1 diabetes, she also helped develop the UVA-run Diabetes Driving study, an ongoing research project whose mission is to understand how drivers with type 1 can better prevent, detect and treat out-of-range blood sugar levels when driving.

According to Shepard, feeling anxious about your teenager with diabetes learning to drive is normal, mainly because it goes with the territory of parenting a child who is rapidly becoming a young adult. “Parental worry is common as children gain independence and start spending more time away from home, which undoubtedly happens more when teens obtain their driver’s licenses,” she says.

To help your child stay safe and keep worry and anxiety manageable, Shepard recommends parents begin communicating expectations and rules about driving and diabetes management before their teen’s first driving lesson. Individual licensing rules for people with diabetes vary by state, but as Shepard outlines, the basic guidelines of staying safe include making sure drivers with type 1 diabetes:

  • Check their blood sugar before they get behind the wheel.
  • Do NOT drive if their blood sugar is low.
  • Treat high or low blood sugar before they drive, even if it will make them late.
  • Keep supplies, snacks, and fast-acting glucose within arm’s reach while driving.
  • Do not store insulin or test strips in the car, as extreme temperatures can damage them.
  • Pull over immediately if they’re feeling sick or suspect they are hypoglycemic and test their blood sugar.
  • Always carry their driver’s license and medical identification.

Maintaining an open and ongoing discussion with your teen about why these rules are important (and the consequences for not following them) can help you gauge your child’s readiness and willingness to responsibly manage his or her blood sugar as a licensed driver.

It’s also key in these conversations to let your child know that you will remain involved in their diabetes management, even when you’re not sitting in the passenger seat.

For example, Shepard notes, parents and teens can come to an agreement that once the teen is licensed to drive, “parents will check the teen’s blood glucose meter after driving trips to confirm that he or she was testing their blood sugar at appropriate times and also not driving while hypoglycemic.”

Parents can also establish rules that require their teen to let them know he or she has all needed supplies, including a fast-acting glucose source, before getting in the car.

Hitting the Road

What does it look like to put these rules into practice? Bennet D.’s 20-year-old son was diagnosed with type 1 diabetes a decade ago. When the Pennsylvania father of four taught his son to drive as a teen, Dunlap says that what he learned was a lesson in trust.

“Teaching a kid with diabetes to drive is a great opportunity to practice trusting your child,” says Bennet. “Yes, there is anxiety, but this is what we’re constantly building towards as parents ... facilitating and enabling our kids to take care of their diabetes in any situation.”

For Bennet, giving his son the “keys to freedom” has meant doing everything he can to make his son’s testing and treating of blood sugars when he’s on his own as easy and convenient as possible. Besides keeping supplies stashed in the car, one of Bennet’s favorite tricks is the canister attached to his son’s keychain that contains test strips. Knowing that his son has the ability to check his blood sugar whenever he gets behind the wheel gives Bennet great peace of mind.

“When I get in the car after my son has driven and find used test strips scattered all over the floor, I’m not upset about my son being messy. I’m happy that I’m seeing evidence of him performing checks, which is exactly what he needs to be doing.”

Bennet can check the canister anytime to see if strips are being used (as well as check his son’s meter). When his son voluntarily tells his dad that he’s running low on strips and needs to refill,  it’s an occasion for some positive feedback.

“When we see our kids doing the right thing, it’s so important to let them know, ‘Hey, you’re doing exactly what you need to do. That’s great!’”

Red Lights 

What about teens who don’t follow the rules of the road? Shepard says that the consequences should be straightforward. “The threshold for taking away driving privileges will vary with each family, but overall if teens are engaging in unsafe driving practices -- for example, not testing their blood sugar, or driving while hypoglycemic -- they should not drive until they can demonstrate better diabetes management and safer driving behaviors.”

It’s usually helpful to follow up with your diabetes educator or doctor to have them discuss with your teen the importance of good diabetes habits when driving. Your care team may also make specific suggestions for encouraging your teen to make safer choices in the future.

A Little Inspiration

For a high-speed lesson in how skilled people with diabetes can become at managing their blood sugars while driving, look no further than NASCAR driver Ryan Reed. Diagnosed with type 1 diabetes at age 18, just as his career was ramping up, Reed decided not to let type 1 derail his dreams. “After being diagnosed, I made up my mind that I wouldn’t let diabetes stop me -- and it hasn’t!”

Now driving the No. 16 American Diabetes Association Drive to Stop DiabetesSM presented by Lilly Diabetes Ford Mustang, Reed is trained to stay focused on the racetrack and the continuous glucose monitor that’s custom-mounted to his dashboard.

“There’s a glucose drink built into my helmet if I’m going low. If I’m high, I have a target on my suit so I can stop and my team can quickly give me an insulin injection.”

Does your teen require the skills of a NASCAR driver in order to safely drive to the mall and back? Probably not. But isn’t is reassuring to know that one of best drivers in the world is someone managing the same issues as your new driver?

 

Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the "typical" experiences of families with a child who has type 1  diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring.

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