Comments on: When Things Get Ugly

By: John Hallett

John Hallett — Sat, 14 Jul 2007 04:36:10 +0000

Hi Amy I’ve had many a low in public have never been arrested but have been put in handcuffs to keep me from hurting myself or others. Have been type 1 since childhood have also had accident with low many years ago not fun. The state I live in requires if you have low regular checkups from the doctor for few years. But have found is the best way is check before you drive if below 100 don’t drive best way to do it. Agree a glucose continous monitor is good thought but they are very expense and the infusions for them are expensive too and insurance doesn’t cover them. Aloso is hard to deal with no insurance too very costly. John

By: Meg Graham

Meg Graham — Fri, 13 Jul 2007 15:48:56 +0000

Jenn (posted 6/4/07), I’m sorry to say that I’d have to disagree with you! Us diabetics do try so hard, and when low blood sugars hit they hit you hard and fast! I test ALL THE TIME and to the point my Dr. said was unnecessary. I too was in a horrible car accident and I injured someone who, of course, sued me. I was hurt pretty bad as well. It hit me so incredibly fast I don’t even remember it happening?? Previous to this I had stopped to get something to eat, but drove along saying I’d eat while I drove. I was too late!
The BEST THING IN THE WORLD for us diabetics is that CGMs and make the insurance companies provide for them. The first few years of being a diabetic, I had “symptoms” of low blood sugar too, but they don’t hit you hard until you’ve had it for quite a while.

By: Sarah

Sarah — Wed, 06 Jun 2007 20:16:01 +0000

P.S. Titos, your comment is also a great potential solution.

By: Sarah

Sarah — Wed, 06 Jun 2007 20:11:05 +0000

The problem is that not everyone has the same degree of control as everyone else, and not all can or will manage as well or as poor as the next diabetic.

It does seem like this driver WAS doing the right thing by correcting his high, provided he took the “right” correction dose suggested by his diabetes educator.

There is a risk for *anyone* with a chronic health condition to be on the road. Same goes for the elderly.

People with Type 2 diabetes may not be prone to lows, but since many Type 2’s are overweight, have high blood pressure, high cholesterol, and/or heart disease, they are at a high risk for a heart attack/stroke behind the wheel causing an accident. I have also heard of Type 2’s who fail to test regularly or take their medication since Type 2 is not immediately fatal. These people drive around with continuous dangerously high blood sugars, which can also impair judgment.

Visual and neurological damage from diabetes can also affect driving ability.

Some Type 1’s also have more lows and swings in blood sugar than others, some of which are unexplained and unpredictable. A minority of those with Type 1 remain stable with few (rare)lows despite tight control. Most people fall in the middle.

Type 1’s who drive probably should give up aim for “tight control” when behind the wheel.

I think diabetes *in general* does increase your risk of dying or killing someone behind the wheel. I just saw a show in which a police officer pulled a man having a “diabetic emergency” out of a car, which had burst into flames.

I don’t know what the answer is here. Perhaps my uncertainty is why I never got my license, and I don’t drive. I’m terrified I’ll go low. My fiance keeps trying to get me a car (probably so he doesn’t have to drive me everywhere , but frankly, I don’t know if a Type 1 like me (Old school term “brittle”) should have one.

I already test 10x per day and wear a pump. Short of getting a CCGM (I agree they should be covered), there is nothing more I can do to stay in “control” behind the wheel. So if I still have unexplained lows and sudden swings, I assume I should not drive.

For those Type 1’s who drive, *please* always test before you get behind the wheel, and take the time to figure out how much insulin/food you have in your system. Run yourself a little higher, and test often.

By: Titos

Titos — Tue, 05 Jun 2007 22:31:25 +0000

Thanks Anne, I think it all comes down to responsibility and discipline – and I guess diabetics learn this the hard way. Another interesting statistic is the following: Finland has the highest incidence of Type 1 diabetes in the world and is one of the few (if not the only) countries that accepts diabetics into the military. A significantly higher percentage of diabetics than non-diabetics then go on to become officers. It is the same effect.

By: Anne

Anne — Tue, 05 Jun 2007 20:23:20 +0000

nicely put, Titos.

By: Titos

Titos — Tue, 05 Jun 2007 17:59:56 +0000

Studies in the UK, Sweden and I believe also in the US have documented that the accident rate of diabetics while driving vehicles is actually lower than non-diabetics. This obviously does not help in this tragic incident, however the discussion should be put in perspective: The vast majority of diabetics, even young people, is very careful when they drive as a low can be life threatening – also to themselves. Obviously insulin dosing is not an exact science yet – and in this case technology needs to help. Using a CGMS while driving seems to me to be a perfect application for the technology given the built in alarms. Perhaps here liability insurance could play a role by obliging diabetics to wear CGMS while driving, which then health insurance / Medicare would be obliged to pay. This should be mentioned to the manufacturers.

By: Pteryxx

Pteryxx — Tue, 05 Jun 2007 16:59:58 +0000

I object to the comparison of diabetic lows with drunk driving. The last I heard, nobody developed life-threatening medical complications from NOT drinking. Diabetics have no choice but to be on an often complicated and unpredictable regimen. Besides, plenty of accidents are caused by the stupidity of people that don’t have a convenient red-flag label as a blame target. Quotes:

“Distracted drivers were involved in nearly eight out of 10 collisions or near-crashes . . . . Data from police reports had estimated that driver inattention was a factor in about 25 percent of crashes.”

“Drowsy driving increased the driver’s risk of a crash or near-crash by four times to six times, the study said. But the study’s authors said drowsy driving is frequently underreported in police investigations.”

(Quotes reported in 2006 NHTSA study.)

The lawsuit-based logic would lead us to ban diabetics from driving, whether or not they have a history of excellent control. But it is discriminatory to hold one class of people to a higher standard of behaviour – not performance, but behaviour – because of a medical condition.

By: Ed

Ed — Tue, 05 Jun 2007 16:18:43 +0000

Mary, Type 1s can do anything that a person without Type 1 can as long as they plan for it and act responsibly. It’s not as if we’re a bunch of people with chronic illnesses who turn into zombies without a warning sign. Precautions and planning allow us to live the same life as anyone else.

By: Mary

Mary — Tue, 05 Jun 2007 15:10:32 +0000

Scenarios like these – both the accidents and the Doug Burns case, should be a big wake up call to people who insist Type I diabetics can do anything from flying airplanes to being policemen to running marathons. IF you add achieving a wonderfully low HA1C to doing anything and everything, you have created a recipe for disaster.

Whether or not the drivers are criminally responsibe for the accidents, I really don’t know what to think. Did they routinely suffer from unexpected lows? Did they routinely lose touch with reality during lows? Then, I’d think they were responsible. Was their care haphazard, or were thy striving for extra tight control? Both extremes increase personal responsibility for the lows.