Vnitr Lek 2019, 65(4):321-325 | DOI: 10.36290/vnl.2019.056

Driver medical fitness and diabetes mellitus: legislative changes in 2018 and a summary of health aspects

Jan Brož1,*, Katarína Halčiaková2, Denisa Janíčková Žďárská1, Ondřej Novák3
1 Interní klinika 2. LF UK a FN Motol, Praha
2 Medifin a.s., Praha
3 Advokátní kancelář AK Panýr, Praha

A review of medical fitness to hold a driver's license in diabetes mellitus patients occurs when applying for the license and then at least every three years in non professional drivers and 1 year in professional ones. Severe hypoglycemic events are an important criterion with the view of eligibility loss to drive a vehicle, among the others the vision impairment, diabetic peripheral neuropathy or extremity amputation should be evaluated. Also the ability of patient to follow recommendations particularly regarding glucose self-monitoring may influence the final decision.

Keywords: diabetes mellitus; hypoglycemia; legislation

Received: September 20, 2018; Accepted: January 31, 2019; Published: April 1, 2019  Show citation

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Brož J, Halčiaková K, Janíčková Žďárská D, Novák O. Driver medical fitness and diabetes mellitus: legislative changes in 2018 and a summary of health aspects. Vnitr Lek. 2019;65(4):321-325. doi: 10.36290/vnl.2019.056.
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References

  1. Brož J, Syčová Kriváňová L, Fedáková Z et al. Řízení motorových vozidel a diabetes mellitus - lékařské aspekty. Vnitř Lék 2016; 62(3): 223-225. Go to PubMed...
  2. Brož J, Syčová Kriváňová L, Janíčková Žďárská D et al. Řízení motorových vozidel a diabetes mellitus - právní aspekty. Vnitř Lék 2016; 62(3): 226-228. Go to PubMed...
  3. [European Commission]. Commission Directive (EU) 2016/1106 amending Directive 2006/126/EC of the European Parliament and of the Council on driving licences. Off J Eur Union 2016; L 183: 59-63.
  4. European Parliament, Council of the European Union. Commission directive 2009/113/EC of 25 August 2009 amending directive 2006/126/EC of the European Parliament and of the Council on driving licences. Off J Eur Union 2009; L 223: 31-35
  5. Vyhláška č. 277/2004 Sb. Dostupné z WWW: <http://docplayer.cz/16726229-Novela-vyhlasky-c-277-2004-sb-2015.html>.
  6. Zákon č. 361/2000 Sb., o provozu na pozemních komunikacích. Dostupné z WWW: <https://www.noveaspi.cz/products/lawText/1/49756/1/2?utm_source=seznam&utm_medium=cpc&utm_campaign=search-zakony-br-always-on&utm_content=Z%C3%A1kon+o+silni%C4%8Dn%C3%ADm+provozu&utm_term=z%C3%A1kon+o+silni%C4%8Dn%C3%ADm+provozu+%C4%8D.+361/2000+sb>.
  7. Stevens AB, Roberts M, McKane R et al. Motor vehicle driving among diabetics taking insulin and non-diabetics. BMJ 1989; 299(6699): 591-595. Go to original source... Go to PubMed...
  8. Songer TJ, LaPorte RE, Dorman JS et al. Motor vehicle accidents and IDDM. Diabetes Care 1988; 11(9): 701-707. Go to original source... Go to PubMed...
  9. Cox DJ, Kovatchev B, Vandecar K et al. Hypoglycemia preceding fatal car collisions. Diabetes Care 2006; 29(2): 467-468. Go to original source... Go to PubMed...
  10. Songer TJ, Dorsey RR. High risk characteristics for motor vehicle crashes in persons with diabetes by age. Annu Proc Assoc Adv Automot Med 2006; 50: 335-351.
  11. Cox DJ, Penberthy JK, Zrebiec J et al. Diabetes and driving mishaps: frequency and correlations from a multinational survey. Diabetes Care 2003; 26(8): 2329-2334. Go to original source... Go to PubMed...
  12. Cox DJ, Ford D, Gonder-Frederick L et al. Driving mishaps among individuals with type 1 diabetes: a prospective study. Diabetes Care 2009; 32(12): 2177-2180. Dostupné z DOI: <http://dx.doi.org/10.2337/dc08-1510>. Go to original source... Go to PubMed...
  13. Campbell LK, Gonder-Frederick LA, Broshek DK et al. Neurocognitive Differences Between Drivers with Type 1 Diabetes with and without a Recent History of Recurrent Driving Mishaps. Int J Diabetes Mellitus 2010; 2(2): 73-77. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ijdm.2010.05.014>. Go to original source... Go to PubMed...
  14. Cox DJ, Gonder-Frederick LA et al. Driving safety: concerns and experiences of parents of adolescent drivers with type 1 diabetes. Pediatr Diabetes 2012; 13(6): 506-509. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1399-5448.2012.00862.x>. Go to original source... Go to PubMed...
  15. Cox DJ, Ford D, Gonder-Frederick L et al. Driving mishaps among individuals with type 1 diabetes: a prospective study. Diabetes Care 2009; 32(12): 2177-2180. Dostupné z DOI: <http://dx.doi.org/10.2337/dc08-1510>. Go to original source... Go to PubMed...
  16. Redelmeier DA, Kenshole AB, Ray JG. Motor vehicle crashes in diabetic patients with tight glycemic control: a population-based case control analysis. PLoS Med 2009; 6(12): e1000192. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pmed.1000192>. Go to original source... Go to PubMed...
  17. Pedersen-Bjergaard U, Faerch L, Allingbjerg ML et al. The Influence of new European Union driver's license legislation on reporting of severe hypoglycemia by patients with type 1 diabetes. Diabetes Care 2015; 38(1): 29-33. Dostupné z DOI: <http://dx.doi.org/10.2337/dc14-1417>. Go to original source... Go to PubMed...
  18. Brož J, Brabec M, Janíčková Žďárská D et al. Fear of driving license withdrawal in insulin-treated diabetes mellitus patients negatively influences their decision to report severe hypoglycemic events to physicians. Patient Prefer Adherence 2015; 9: 1367-1370. Dostupné z DOI: <http://dx.doi.org/10.2147/PPA.S87393>. Go to original source... Go to PubMed...
  19. Cox DJ, Gonder-Frederick LA, Kovatchev BP et al. The metabolic demands of driving for drivers with type 1 diabetes mellitus. Diabetes Metab Res Rev 2002; 18(5): 381-385. Dostupné z DOI: <http://dx.doi.org/10.1002/dmrr.306>. Go to original source... Go to PubMed...
  20. Warren RE, Frier BM. Hypoglycaemia and cognitive function. Diabetes Obes Metab 2005; 7(5): 493-503. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1463-1326.2004.00421.x>. Go to original source... Go to PubMed...
  21. Inkster B, Frier BM. The effects of acute hypoglycaemia on cognitive function in type 1 diabetes. Br J Diabetes Vasc Dis 2012; 12(5): 221-226. Dostupné z DOI: <https://doi.org/10.1177/1474651412466273>. Go to original source...
  22. McCrimmon RJ, Deary IJ, Huntly BJ et al. Visual information processing during controlled hypoglycaemia in humans. Brain 1996; 119(Pt 4): 1277-1287. Go to original source... Go to PubMed...
  23. Cox DJ, Gonder-Frederick L, Clarke W. Driving decrements in type I diabetes during moderate hypoglycemia. Diabetes 1993; 42(2): 239-243. Go to original source... Go to PubMed...
  24. Cox D, Gonder-Frederick L, Kovatchev B et al. Julian D, Clarke W. Progressive hypoglycemia's impact on driving simulation performance. Occurrence, awareness and correction. Diabetes Care 2000; 23(2): 163-170. Go to original source... Go to PubMed...
  25. Zammitt NN, Warren RE, Deary IJ et al. Delayed recovery of cognitive function following hypoglycemia in adults with type 1 diabetes: effect of impaired awareness of hypoglycemia. Diabetes 2008; 57(3): 732-736. Dostupné z DOI: <http://dx.doi.org/10.2337/db07-0695>. Go to original source... Go to PubMed...
  26. Pedersen-Bjergaard U, Faerch L, Allingbjerg ML et al. The Influence of new European Union driver's license legislation on reporting of severe hypoglycemia by patients with type 1 diabetes. Diabetes Care 2015; 38(1): 29-33. Dostupné z DOI: <http://dx.doi.org/10.2337/dc14-1417>. Go to original source... Go to PubMed...
  27. Brož J, Brabec M, Janíčková Žďárská D et al. Fear of driving license withdrawal in insulin-treated diabetes mellitus patients negatively influences their decision to report severe hypoglycemic events to physicians. Patient Prefer Adherence 2015; 9: 1367-1370. Dostupné z DOI: <http://dx.doi.org/10.2147/PPA.S87393>. Go to original source... Go to PubMed...
  28. Sommerfield AJ, Deary IJ, Frier BM. Acute hyperglycemia alters mood state and impairs cognitive performance in people with type 2 diabetes. Diabetes Care 2004; 27(10): 2335-2340. Go to original source... Go to PubMed...
  29. Cox DJ, Kovatchev BP, Gonder-Frederick LA et al. Relationships between hyperglycemia and cognitive performance among adults with type 1 and type 2 diabetes. Diabetes Care 2005; 28(1): 71-77. Go to original source... Go to PubMed...
  30. Yale SH, Hansotia P, Knapp D et al. Neurologic conditions: assessing medical fitness to drive. Clin Med Res 2003; 1(3): 177-188. Go to original source... Go to PubMed...
  31. Inkster B, Frier BM. Diabetes and driving. Diabetes Obes Metab 2013; 15(9): 775-783. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.12071>. Go to original source... Go to PubMed...
  32. [DVLA]. At a glance guide to the current medical standards of fitness to drive. Swansea: Driver & Vehicle Licensing Agency; 2014. Dostupné z WWW: <https://bpna.org.uk/pr3ss/wp-content/uploads/2012/04/9.2-DVLA.pdf>.




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