Q: My son is about to turn 16 next month and is really excited to get his driver’s license. Are there any special safety considerations since he has type 1 diabetes?
A: Teaching teens to be safe drivers can be a challenge. When it’s a teen with type 1 diabetes getting behind the wheel for the first time, staying safe requires learning a few extra rules of the road related to maintaining good blood sugar control.
Experiencing low blood sugar (hypoglycemia) is one of the most serious diabetes-related risks for drivers with type 1. Your care team can offer more specific advice for preventing lows based on your child’s needs, but in general, the first step to safe driving with diabetes is to check blood sugar levels before heading out -- ideally 30 minutes before beginning operation of the motor vehicle. What kind of number are you looking for? A reading slightly on the high side of in-range is considered optimal under most circumstances. On your part, try to get in the habit of asking your son his number before handing over the keys. If he’s running high or low, it’s important for him to understand that he must correct and recheck before he gets the green light to go.
In the car, your teen should have access to his diabetes supplies, including a blood glucose meter and a stash of rapidly absorbed carbohydrates. In the event he does feel low, he needs to stop driving immediately. Just like you don’t want your child to text and drive or drink and drive, you also don’t want him treating a low and driving. It’s a good idea to practice with your teen how to safely pull over onto the shoulder in different traffic situations. Once he’s safely off the road, he can then check his sugar and treat as needed. Most parents also require their children to call or text them in this situation. In any event, after a low, your son should not drive until his numbers are back within range and he’s feeling okay. This may take up to 20 minutes or longer.
One way to enforce good habits is to investigate with your teen what your state’s laws are concerning drivers with diabetes. In some states, having any kind of driving mishap as the result of an episode of hypoglycemia may result in an immediately suspended driver’s license. Other states have even more stringent rules where any episode of hypoglycemia reported to the DMV -- even when the person was not driving at the time -- can result in a suspension. Knowing what’s at stake can help teens see the very real consequences of their actions and to encourage good monitoring habits.
We also have valuable information about which teens (and adults) with diabetes may be at highest risk for having an accident related to low blood sugar, thanks to a 2009 Diabetes Care study in which a group of drivers with diabetes were tracked for 12 months. A history of collisions or severe hypoglycemia put drivers at increased risk for accidents. Interestingly, the study found that having a hypoglycemia-related driving mishap was not related to such factors as the sex of the driver, how long the driver had been living with diabetes, his or her A1C numbers, self-reported hypoglycemic awareness, or availability of fast-acting glucose in the car.
What does this mean for your teen? When it comes to driving, it’s critical to have a mature, logical and ongoing discussion with your child about why the rules are so important for their safety. It’s one thing to just give your teen a list of do’s and don’ts but another to help him understand and embrace the fact that taking certain steps now can keep him on the road and driving for years to come. If you need help getting this conversation started, don’t hesitate to reach out to your diabetes care team.
--R. Daniel Pollom, M.D., is senior medical advisor at Lilly Diabetes.
How Other Parents Deal
“Our diabetes clinic holds a teen driving class to teach kids all about blood sugar and driving and what to do in case of emergency. At home, he knows that if he slacks off with checking his blood sugar, there will be no more driving privileges until he can prove himself again. This is just a non-negotiable, and so far, it seems to be working.”
--Kristin G., mom of 16-year-old David
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.
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