I’ve had a very prompt response from the information team, and the policy team will be looking into it further.
Has there been any updates to this?
I re-read INF188/2 yesterday after someone on the forum asked about the driving rules (in the thread below) to see if anything had changed. But there has still been no update to the leaflet.
It is all well and good the shadowy figure behind the scenes saying that they direct people to the guidance for medical professionals as it is in the public domain, but how many diabetics do they get to talk to? At no point was I ever told by anyone to read it, nor told to ignore the advice the government specifically published to explain what a driver needs to do.
And it would never have occurred to me to just assume such advice might be wrong, assume there exists a document aimed at medical professionals, assume it is publicly available, and assume I need to read it to know what I should do. It is near impossible to think anyone who is not a obsessed with detail as me would ever end up going down such a chain of events!
No would I expected doctors to examine every bit of information to discover that the publicly stated advice does not match that which is shared with them. I do not recall being told anything at all, but had I been it would no doubt have been just to read the government leaflet. Unless a doctor has concerns over someone's fitness to drive, why would they do anything other than direct them to that?
I also disagree with the shadowy figures's statement that
Blood glucose testing 2 hours before and every 2 hours during is required for people taking sulphonylureas and glinides – see 76
Page 76 only says those on such medications "should practise appropriate glucose monitoring at times relevant to driving." Nowhere does it define what is appropriate. This is in contrast with the guidance for those who take insulin (page 72) where it instead states someone issued a licence "practises appropriate glucose monitoring as defined in the box below," the box setting out the two-hour rules as in leaflet INF294. The box is also titled "Group 1 and Group 2 requirements for insulin-treated drivers licensed on review," so is unambiguously in not being relevant to those on sulphonylureas.
This is also relevant to my curiosity on discovering the different guidance that C.C.G.s have for testing requirements and prescribing test strips to patients with T2DM. Most do state that more strips should be prescribed if necessary to meet D.V.L.A. requirements, but as those requirements are not defined it does not help patients ensure they receive enough.
I pointed out the Walsall guidance in the thread below, and they state for those on sulphoylureas that there is no need to routinely test, and only give HGV and PSV drivers in the list of exceptions to that. Normally when the weather is good I would go on 300–400 mile day trips on my bike at the weekend, so have been testing 7–8 times to satisfy the D.V.L.A. Even in an abundance of generosity, had I moved to Walsall a second pot every three months would have still quickly ran out. Even their one pot per month for insulin treated T2DM would not last in a good month.
Obviously none of this applies to me now anyway, but I still think it is an important issue. Because it seems that the D.V.L.A. have an undefined requirement that is kept secret from the public, and that medical professionals do not really understand either.
I think Diabetes U.K. needs to talk to the D.V.L.A / government to:
* Define what is the appropriate level of testing for those treated by sulphonylureas and glinides.
I never had a hypo while riding, I never was told to test when doing so, I have hypo awareness, so for me not testing never seemed inappropriate. I am guessing in hindsight the D.V.L.A. would disagree, but technically I was following their unbeknownst-to-me rule.
* Update leaflet INF188/2 so that diabetics and not just medical professionals are aware of such a rule.
Even if they want to stick with the ludicrously vague "appropriate," at least tell people they should be using their judgment rather than expecting them to spontaneously realize they need to seek out documents aimed at medical professionals/
* Ensure N.H.S. commissioning groups and trusts are aware of the requirements.
So that it gets included in policies and patient can ensure access to testing rather than having to fight to meet such rules. In the thread above, Lucyr said how she had to fight to get more test strips despite being on M.D.I. therapy so needs to follow the two-hour testing rules. There is probably also a case for discussions with the N.H.S. or NICE for standard policies on testing requirements for T2DM on sulphonylureas or insulin, though that is another matter.
