Amendments made to driver medical standards relating to diabetes

Recent amendments made to driver medical standards aim to ensure that the guidelines relating to ‘satisfactory control of diabetes’ are clearly understood, accorDiabetesding to the National Transport Commission (NTC).

NTC Project Director, Dr Jeff Potter, said that the new wording clarifies the intent of the guidelines.

“The purpose of the guidelines surrounding a driver’s satisfactory control of their diabetes is to indicate whether the driver needs further assessment to determine their fitness to drive,” said Dr Potter.

“It is  not an absolute requirement for holding a driver’s licence.”

The role of Assessing Fitness to Drive is to provide guidance to medical professionals and driver licencing authorities in establishing fitness to drive for private and commercial drivers.

The standards aim to protect all road users and provide a crucial element to improving road safety. A new edition of Assessing Fitness to Drive came into effect in March 2012, following a comprehensive revision process undertaken by the NTC and Austroads.

The process included extensive consultation with medical experts to ensure that the standards draw on the most recent research and expert opinion on the impact that various chronic medical conditions have on driving ability and crash risk.

Under the previous (2003) version of Assessing Fitness to Dr, a person   who had insulin-requiring diabetes mellitus (both Types 1 and 2) was eligible   for a conditional private driver licence if his or her diabetes was  “well controlled”.

No guidance was given as to what “well controlled” meant.

“During consultation on proposed changes to Assessing Fitness to Drive, both doctors and patients advised the NTC that greater guidance on the meaning of ‘well controlled’ was required, so the 2012 edition addresses this,” said Dr Potter.

A person who has insulin-treated diabetes can drive under a conditional private driver licence if his or her diabetes is “satisfactorily controlled”. Following feedback from stakeholders, the NTC has now inserted the following additional wording to clarify what “satisfactorily controlled” means:

“A (glycated haemoglobin) HbA1c level of 9.0% or higher should usually trigger a formal consultation and assessment by a specialist or clinician experienced in the management of diabetes, in order to assess fitness to drive”.

The NTC worked closely with the Australian Diabetes Society in making the revision, which was approved by heads of state and territory transport departments and roads authorities.

“It is important to remember that the guidelines are designed to allow medical practitioners to make their own clinical judgements as to whether drivers are satisfactorily controlling their diabetes on a case-by-case basis,” said Dr Potter.

Assessing Fitness to Drive also includes an increased focus on severe hypoglycaemic events and lack of hypoglycaemia awareness as particular risks to driving, with guidance regarding recognition and management.

Assessing Fitness to Drive as well as related information can be downloaded from the Austroads website.

Doctors or other health professionals who have any questions about undertaking driver health assessments should contact their local driver licensing authority.

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