A global survey of licensing restrictions for drivers with diabetes

Abstract

Background: Ensuring medical fitness to drive is an important safety measure for people with diabetes and is a prerequisite for a driving licence in many countries. Objectives: To ascertain the current regulatory restrictions on drivers with diabetes currently being applied internationally. Methods: An electronic survey (in English) was sent to contacts of member organisations of the International Diabetes Federation and to selected specialists in diabetes. Questions addressed the regulations in place for insulin-treated drivers. Results: Information on licensing was obtained from 85 countries. No restrictions on drivers with insulin-treated diabetes existed in 59 countries (69.4%). Medical assessment of some type was required in 29 countries (34.5%). They were performed by different people and at different time intervals. Emphasis was placed on conditions causing potential risk to driving safety. When insulin is introduced to a licensed driver's treatment, in most countries the driver is permitted to continue driving without any change in licensing entitlement (n=68; 80%); in 16 countries (19%) a driver can retain their driving licence subject to special conditions and in one country the driver will have the driving licence revoked permanently. With respect to large goods vehicles and passenger-carrying vehicles, no restrictions or assessments are required for drivers with insulin-treated diabetes in most responding countries (n=56; 66%); licensing is permitted with some restriction in 23 countries (27%) and prohibited in six countries (7%). Conclusions: There is a wide variation between different countries and global regions in the statutory requirements and policies used to regulate and assess drivers with diabetes. The lack of regulation in many countries may adversely affect public safety.

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“…A recent international survey that included 85 countries revealed a total lack of licensing restrictions in 59 (69.4%) while medical assessment of some type was required in 29 (34.5%) countries. That survey has also revealed that the absence of statutory restrictions is more common in countries with lower economic status and is associated with higher rates of road traffic fatalities [7].…”

Diabetes, driving and fasting during Ramadan: the interplay between secular and religious law

“… 21 Globally, there is a wide variation between different countries and regions in the statutory requirements and policies used to regulate and assess drivers with diabetes. 22 …”

“…In a recent international study, no restrictions on drivers with insulin-treated diabetes existed in 59 out of 82 surveyed countries (69.4%). 22 Lack of restrictions on licenses in drivers on insulin was evident in less developed countries, indicated by geographic basis and by using an established national social/political/economic index (gross domestic product). 22 …”

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“…A recent global survey of 85 countries revealed wide variation in practice and, surprisingly, many national diabetes organisations declined to provide information about the legislation (which is mostly non-existent) on the position regarding regulations for driving licensing in their countries. 9 Of the countries in South-East Asia who responded to this survey, none currently impose any form of licensing restriction on drivers with diabetes, unlike most countries in Europe, North America and Australasia. It was particularly disconcerting to find that, in two-thirds of those countries, no restriction is placed on the driving of large goods vehicles (Group 2 classification in Europe) by people with insulin-treated diabetes, and a 'call to arms' from concerned diabetes specialists in some of the countries with either no or less stringent regulation has been ignored.…”