5 Tips to Remember When You Get Behind the Wheel with Diabetes

drivingWith technological advances and a deeper understanding of diabetes management, people with diabetes have very few limitations. And fortunately, driving a car is not one of them. With the right preparations, anyone with diabetes is able to safely operate a motor vehicle. We spoke with Joslin diabetes educator Erin Kelly, RN, BSN, Certified Diabetes Educator (CDE) in the Adult Clinic at Joslin Diabetes Center, for some helpful guidelines for safe driving with diabetes.

  1. Always Check Blood Glucose Levels Before Operating a Car

Before getting behind the wheel, always do a blood sugar check. “We like to see blood sugars above 100 before driving,” says Kelly. It is unsafe to operate a car if your blood sugar is low as you might experience delayed reaction time, blurry vision, and other impaired cognitive abilities. On the other hand, watch out for high blood sugars. According to Kelly, people can feel tired and sluggish if their blood sugar is too high. Another concern is that if you get into an accident while your blood sugar is low, you could lose your license, so make sure to always keep your meter or CGM close by while driving and check each time you get in the car.

  1. Watch for Low Symptoms

As mentioned above, low blood sugar poses the biggest danger to driving with diabetes.

Low blood sugar symptoms may vary for each individual, but hypoglycemia has the same impact on driving abilities. “If you’re low, your brain does not work properly,” says Kelly. “You won’t have the same decision making skills that are necessary for driving a car.” If you do experience a low blood sugar while driving, pull over immediately to treat the low and wait to resume driving until your blood sugar is at least over 100.

  1. Keep Your Car Stocked

Whether the driver or a passenger has diabetes, stash plenty of low treatment in your car in case of an emergency. Kelly suggests keeping low treatments that are in reach and easy to open, such as juice or glucose tablets. “We always recommend that you have something fast acting within arm’s reach if you are driving,” says Kelly. “Don’t keep it in the glove box, trunk, or backseat, but either next to you or in the center console. That way you if you are going low, you can just grab it.” Peanut butter, nuts, or protein bars are also perfect longer-acting snacks that can be easily stored in a car.

  1. Going on a Road Trip? Plan in Advance

If you’re hitting the road this summer for a trip, it’s always a good idea to plan in advance. Like any trip, extra diabetes supplies should be on your checklist, but you should also stock up on extra snacks and drinks beforehand.  If you are the one driving, you will also need to check your blood sugar levels more frequently. “Even if you think your blood sugars are normal, you would need to stop every so often to check and make sure your glucose is stable,” says Kelly. “We recommend checking at least every hour and half to two hours on a long drive.” Remember to take breaks during long car rides and eat something if your blood sugar is borderline 100 or below.

  1. Keep Cool This Summer

When it comes to summer and diabetes, the two don’t always get along. The heat can have damaging effects on diabetes devices and medications. “Insulin is the biggest concern with regard to heat,” says Kelly. When exposed to extreme temperatures above room temperature, it becomes ineffective. “Never leave your insulin in the car or in direct sunlight exposure,” recommends Kelly. If you’re going to be in the car for a long period of time, there are portable coolers for storing your insulin. At the same time, insulin should never be frozen. If you put insulin next to an ice pack, make sure to have a towel separating the two.

For more information about driving with diabetes or to answer any questions about diabetes management, contact our Certified Diabetes Educators at 617-309-2780 or make an appointment with our Adult Clinic at 617-309-2440. 


  1. This is a great article. I got into a very bad accident with my car. No people were hurt and I was not hurt but the damage to the car was $15,000. My blood sugar dropped to 32 and I blacked out and crashed into a median. So I have been going through a state investigation in NY to see if I should be allowed to keep my licence. That is the only thing I would of mentioned is the conquences of not doing the prevention before driving a car especially in a Urban area such as Boston or Long Island NY where I live. Right now it looks like I may not be penalized because this has never happened before and I have had expert doctors say that I have taken the precautions that your article suggests. So I think I dogged a tough one. NY is a very tough state if you have a problem medically and are in an accident. So please I suggest a follow up article to say what can happen if a diabetic does not take precautions before getting behind a wheel of a car. Also be sure to discuss with your doctor how they would respond to a car accident issue with their states DMV. I thought I had a Nurse Practioner that was on my side instead she wrote I should not be allowed to drive. This was a first visit to the Nurse Pract. Because of this incident with the NP grrrrrr I got a very very top notch Insulin Pump doctor (Yes I have been on the pump since 1981, Joslin saved my life by getting me on the very basic pump at that time) and a excellent diabetic Psycologist. They both worked as a team and they with the written answers and the blood tests and the changes we made to my pump and diet and when I should not drive (At night not good eyesight) may of saved me from losing my drivers licence! I constantly monitor my blood sugars 6-8 times a day and adjust my pump settings as needed. So if you want to talk to me about my experience with car driving and diabetes I am a Joslin Patient a member of the 50 year club and so I am in Boston often. I would be very happy to discuss my experiences as a follow up article.
    Thank you for this article
    FYI I am a 54 year old Type I diabetic. I got my diabetes in 1963 at 18 months of age. I never had a reaction and blacked out before. So this incident with the driving accident woke me up to tighten up my control.
    So I think your article was great and thank you for writing it and if I can help please let me know.
    Garret A. Ross, PhD

    • Hi.. First, thank you for your post, Mr Ross. I am sorry you have this disease. My husband of 26 years was killed by a negligent Type 1 diabetic in March of 2017. I say negligent because he made a series of fatal errors in judgement that day and had been having multiple lows (10-15/week) for six months prior to the accident. This driver had severe hypoglycemia, choose to get behind the wheel, remembers nothing, drove erratically for 18+ miles on a State Hwy in WI and ran multiple people off the road before crashing directly into my husbands car at a vector of -45mph. He was crushed and died instantly of an aortic tear.

      The other driver was only fined $213.00 for crossing the center line and did not lose his license or have any restrictions until he could be proven safe behind the wheel.

      My brother is a Type 1 diabetic, and a physician who treats diabetic patients and regularly treats non-compliant patients. He tells our tragic story to each of them as well as at conferences with other physicians in the diabetic field.

      I hope to someday work to raise awareness regarding Type 1 diabetics, low blood sugar and driving. I believe that a standard of at least 100mg/DL testing before driving could help prevent tragedies such as ours. Our 17 yr old daughter also has to live for the rest of her life without her loving, supportive father. We both want to work to prevent the trauma and pain we are experiencing to losing someone we loved very much to a preventable accident.

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