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Table 1 Recommendations for safe driving practice for drivers with insulin-treated diabetes [25, 72]

From: Driving and diabetes: problems, licensing restrictions and recommendations for safe driving

• Always carry your glucose meter and blood glucose strips with you
• Check your blood glucose no more than 1 h before the start of the first journey and every two hours whilst you are driving
• If driving multiple short journeys, it is not necessary to test before each additional journey as long as you test every 2 h while driving. More frequent testing may be required in circumstances where a greater risk of hypoglycemia is present, e.g., after physical activity or altered meal routine
• Try to ensure that blood glucose is kept above 5.0 mmol/l (90 mg/dl) while driving. If your blood glucose is 5.0 mmol/l or less, have a snack. Do not drive if blood glucose is less than 4.0 mmol/l (72 mg/dl) or you feel hypoglycemic
• If hypoglycemia develops while driving, stop the vehicle in a safe location as soon as possible
• Always keep an emergency supply of fast-acting carbohydrate such as glucose tablets or sweets within easy reach inside the vehicle
• Do not start driving until 45 min after blood glucose has returned to normal (confirmed by measuring blood glucose). It takes time for the brain to recover fully from hypoglycemia
• Carry personal identification to indicate that you have diabetes in case of injury
• Particular care should be taken during changes of insulin regimen, change in lifestyle, following exercise, during travel and during pregnancy
• Take regular meals, snacks and periods of rest on longer journeys. Do not drink alcohol before, or while driving