Aims: To assess knowledge of, and adherence to, current driving recommendations in drivers with insulin-or tablettreated diabetes. Methods: People on a large customer database were contacted by ordinary mail (73,000) or email (95,000) and invited to complete a 17-point survey about diabetes and driving. Only drivers with diabetes receiving treatment with glucose-lowering medications and/or insulin were included. Data from respondents were analysed by an independent research company. Results: The response rate was 14% (n=23,742), of whom 16,172 (10% of the total database) were eligible for inclusion in the analysis. Only 66% of eligible participants were fully cognisant of driving safety recommendations. Adherence to blood glucose testing before driving and during long journeys was limited in insulin users at 47% and 41% respectively. Hypoglycaemia while driving was experienced by 13.1% of insulin users and 1.5% on tablets; 203 (1.3%) of drivers surveyed reported that a motor vehicle accident had been a consequence of hypoglycaemia. Conclusions: Drivers with diabetes appear to have a significant deficit in knowledge about driving safety recommendations and glucose monitoring. This may impose a greater risk of hypoglycaemia while driving, and enhance accident risk. Br J Diabetes Vasc Dis 2015;15:20-23