A global survey of licensing restrictions for drivers with diabetes

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.