Distinguish between waking hypoglycaemic episodes and nocturnal hypoglycaemic episodes when reviewing driving licence eligibility, ensuring that all decisions are considered carefully in the context of the individual.
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In 2011 an EU directive was brought into place by the DVLA giving stricter driving guidance for people with Diabetes Mellitus. Under this Directive, the DVLA does not recognise the difference between conscious hypoglycaemic episodes and asymptomatic nocturnal hypoglycaemia. Furthermore, and against its own statement, it does not consider all cases individually.
Hypoglycaemia is defined as a "low blood glucose level – that is a blood glucose level less than 4 mmol/l. This is too low to provide sufficient energy for your body’s activities." (Diabetes UK). Asymptomatic nocturnal hypoglycaemia however occurs when a person is sleeping and there is a sudden drop on blood glucose levels. In this state an individual is very unlikely to feel the symptoms coming on, even if they have good hypo awareness when awake.
The EU directive states that a person “Must not have had more than one episode of hypoglycaemia requiring the assistance of another person in the preceding twelve months”. If this is the case the DVLA will immediately suspend the individual’s driving licence. However, neither the DIAB1 form nor the DVLA take into consideration medical guidance from the individual’s GP or Specialist Consultant under these circumstances. In addition, they do not consider the context of how these hypo’s occurred.
In my case I have been a type one diabetic for 18 years and have been driving for six years. I have an excellent hbA1c and my blood glucose levels are controlled. I have full awareness of my hypo’s when awake, and always ensure my blood glucose level is above 5.5 mmols before driving. I have never had a hypo whilst driving and take measures to avoid this at all times. I am a healthcare professional and use my car for work.
I had two night time hypo’s in June 2014, whilst I was in a deep sleep. These two hypo’s were caused by the sudden increase in temperature as the summer began, and whilst I was in the middle of a stressful university module and working full time. I did require assistance from my partner as I was in a deep sleep and therefore I did not feel it coming on, however I did not require paramedics and was not hospitalised. These two hypo’s were uncommon and resolved quickly with guidance from my Diabetic Specialist Nurses. No further hypo’s occurred and my Consultant stated he was happy for me to continue to drive.
When renewing my licence as I do every three years, I completed the DIAB1 Form and I ticked “yes” to the box which said “Have you had more than one episode of severe hypoglycaemia (requiring assistance from another person) in the last 12 months?” There was no additional space to explain the cause of these hypo’s, however when completing the DIAB1 I signed a consent form allowing the DVLA to review my medical records to aid their decision. I also included an additional letter explaining the problem and that my Consultant was happy for me to continue to drive. Two months after sending in my reapplication I received a letter stating that my licence had been suspended on the basis of these two hypo’s.
When I contacted the DVLA I was informed that this decision was based on the new EU directive and that they would not contact my GP/Consultant for medical advice as I no longer met the requirements to hold a driving licence. Additionally they did not and would not review my medical notes.
When the EU directive was brought into place in 2011, Diabetes UK and David Cameron raised concerns about the legislation and the impact this would have on diabetic drivers. However, despite these concerns and the number of diabetic drivers who wrongly continue to lose their driving licenses, no change has been made to the current legislation.
There have been many other diabetics who have had the same issues and whose circumstances have been very similar to my own. For example the case of Martyn Lloyd-Kelly who also campaigned against this unfair treatment.
On the 30th October 2014 I sent a letter to 10 Downing Street to raise my concerns. I received a letter back from the DVLA Strategy, Policy & Communications Directorate on 6th November 2014 who were asked by Downing Street to deal with this response. The letter advised that this issue would be considered under the European Commission’s Regulatory Fitness and Performance Programme (REFIT) who aim to identify burdens, gaps and inconsistencies in EU regulations and the DVLA felt this was an appropriate issue to raise. This development is a positive step towards a change for the better. It is now important that we keep this issue in the spotlight. In order to do this, please help to support us to make changes to this unfair and discriminative leglisation by signing the petition:
“Distinguish between waking hypoglycaemic episodes and nocturnal hypoglycaemic episodes when reviewing driving licence eligibility, ensuring that all decisions are considered carefully in the context of the individual.”
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