Driving
For the vast majority of people with diabetes, it will have very little impact on their capacity to drive. However, there are a few practical and regulatory considerations where your patient may require advice.
When does the patient have to inform the DVLA that they have diabetes? 
If the patient has insulin treated diabetes there is a legal requirement to inform the DVLA at the earliest possible opportunity.
In addition, they must inform the DVLA if they have a number of other diabetes related conditions including:
1. Frequent hypoglycaemia.
2. More than one episode of disabling hypoglycaemia per 12 months.
3. Disabling hypoglycaemia while driving.
4. Hypoglycaemia unawareness.
5. Retinopathy.
6. Neuropathy.
7. Visual impairment worse than 12/60 bilaterally.
8. Other lower limb disability.
When is the patient not obliged to inform the DVLA that they have diabetes?
Patients with diet-only treated diabetes and patients with tablet treated diabetes who have good control without any significant hypoglycaemia, diabetic complications or other medical impediment to safe driving do not need to inform the DVLA.
How does the patient inform the DVLA that they have diabetes?
By downloading the form DIAB1 from DVLA website, completing, and returning it.
What are the implications for car insurance?
Many insurance companies will not enquire about a diagnosis of diabetes nor weight the premium. Some, however, do.
Patients should be advised to shop around to find a company that will not weight their policy if their usual insurer does do this.
It is always a good idea for patients to inform their insurer about their diagnosis.
What practical advice should I give my patient about driving with their diabetes?
Patients should be routinely advised to check their blood sugar before driving off; not to set off if it is below 7 mmol/L; and, to keep a source of rapidly absorbed carbohydrate in the car and stop to check blood sugars periodically during a long car journey.
What kinds of vehicles can an insulin-treated diabetic not drive?
LGVs (7.5 tons and over), PCVs (buses, including minibuses of 16 seats or over), trains, planes and 'blue light' emergency vehicles.
It is possible to apply for a C1 exemption to drive a van of 3.5 to 7.5 tons but there are stringent regulations around this area and the driver will need an annual medical report in order to continue to hold this licence.
People with T2DM treated with tablets and/or GLP1 agonists are allowed to drive LGVs, after they have informed the DVLA and undergone medical examination.
What about minicab drivers?
The DVLA recommends that insulin treated taxi and minicab drivers should be allowed to continue to drive.
However, the licensing of minicab drivers is the responsibility of the metropolitan authority/town council where they work. Regulations are quite variable around the country but many authorities do not bar insulin treated patients from driving mini cabs.
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