A serious hypo

[Vince_UK]

That is my point though, with a blood sugar that is low (or possibly not yet low, but falling and therefore producing symptoms) judgement is impaired. There have been many occasions when I have delayed making the correct decision and in retrospect realise that the actual fact I am going low is the cause for the delay as you can overthink things and the reduction in rationality can be very subtle. Effectively, you have to think rationally about whether you are being rational in your decision-making, whilst not being capable of fully-rational thought processes. Personally, I'm glad I don't drive so I will never be placed in this situation.

I'm not saying that this wasn't a situation without potentially very serious consequences, just trying to explain what can happen which is very difficult if you have no direct experience of it.

In which case Northie, if someone is prone to such events then they really need to consider the potential effects of continuing to drive.
I am sorry I find the whole episode irresponsible, seeing as they didn't feel like eating, avoidable, by "worrying about getting lost in Birmingham" and inexcusable by continuing to drive. There is absolutely no justification for this whatsoever.

 

[Bubbsie]

That is my point though, with a blood sugar that is low (or possibly not yet low, but falling and therefore producing symptoms) judgement is impaired. There have been many occasions when I have delayed making the correct decision and in retrospect realise that the actual fact I am going low is the cause for the delay as you can overthink things and the reduction in rationality can be very subtle. Effectively, you have to think rationally about whether you are being rational in your decision-making, whilst not being capable of fully-rational thought processes. Personally, I'm glad I don't drive so I will never be placed in this situation.

I'm not saying that this wasn't a situation without potentially very serious consequences, just trying to explain what can happen which is very difficult if you have no direct experience of it.

That clearly wasn't what happened here...if you read the post he accepts he knew there was a hypo coming on...the only reason he chose not to pull off the motorway was because he did not want to get lost...that is germane to the replies there have been pointing out how dangerous this was...and how it could have been avoided entirely...if he were to be prosecuted (and I am not saying I want him to be or he should be)...he would have no defence whatsoever.

 

[Robin]

That clearly wasn't what happened here...if you read the post he accepts he knew there was a hypo coming on...the only reason he chose not to pull off the motorway was because he did not want to get lost...that is germane to the replies there have been pointing out how dangerous this was...and how it could have been avoided entirely...if he were to be prosecuted (and I am not saying I want him to be or he should be)...he would have no defence whatsoever.

Unfortunately, when a hypo occurs, you think you are behaving rationally and making rational decisions, but because your brain isn't getting enough glucose, you actually aren't rational at all. Fortunately this has never happened to me whilst driving, but my daughter has had to steer me into a shop doorway and say 'for goodness sake, you're hypo, treat it NOW!' when I've been convinced I'm behaving perfectly normally. I know I'm hypo, but my brain is telling me I've got plenty time to deal with it, because it isn't functioning normally. In the end, instinct normally kicks in, and you do the right thing, but it's not always as quickly as you would if you were functioning normally. It's taken me a while to understand this, and develop a 'conditioned reflex' whereby I stop and treat a hypo automatically, without it having to pass through my brain.
It's a tricky one, this. There are some that would say, in that case, no diabetic on insulin ought ever to be allowed behind a wheel just in case their brains don't tell them to pull over straight way. (But on that basis, no parent should ever drive with children in the car, in case they start arguing and distract the parent. As was the case when I got hit from behind by a man turning round to remonstrate with his kids, in both cases, you would be guilty of driving without due care and attention, or worse.)
I think zulodog was caught unawares, not realising that his judgement would be impaired, and now he knows, I doubt he will ever let this happen again.

 

[Sprogladite]

I don't think anybody is disputing that this was very dangerous or that it could have turned out far worse than it did. However unless you have personally experienced the way in which hypos can affect your decision making process then it will appear black and white to you. Decisions made whilst hypo can feel completely rational and sound even if they're bonkers to anyone else. I once spent 15 minutes whilst hypo picking individual biscuits out of a packet and placing them in the bin, and moving the cutlery from the drawer into the fridge. It made sense at the time to me. The point is, the decision to continue on for fear of getting lost, or even the decision not to eat, can feel perfectly rational whilst you are low, even if looking back you realise it wasn't the best decision to carry on...which @zuludog has acknowledged. It is not as simple as some of you are trying to say it is.

 

[Pumper_Sue]

I think zulodog was caught unawares, not realising that his judgement would be impaired, and now he knows, I doubt he will ever let this happen again

His actions need to be looked at carefully he states what his medication is but doesn't state he reduced his insulin in any way or form but as wasn't hungry he ate a cereal bar for breakfast. Well if this was the case and it's way below his normal carb intake then hello there's only one thing that's going to happen.
There is no excuse what so ever for his actions but thank God no one was injured or killed.

 

[Lisa66]

All very good points made. Shall we move on before zuludog feels like he’s been stood up in front of the class?

 

[Bubbsie]

All very good points made. Shall we move on before zuludog feels like he’s been stood up in front of the class?

Agree Lisa

 

[HOBIE]

See if you can follow this; it helps if you have some knowledge of the motorways around Birmingham
For all the 20 years that I have had T2, treated with Glargine, Novorapid, and Metformin I have driven with no problems. Only once did I feel a hypo coming on, and I was able to stop and rest & have something to eat; but on ordinary roads it is fairly easy to stop or come off onto a minor road

I had visited friends in Gloucestershire last weekend, which should not have been a problem as I have been up & down the M5 & M6, lots of times before, and even Spaghetti Junction isn't usually a problem if you take it carefully

I was driving back yesterday, Monday 25th June
It was very hot ( found out later it was the hottest day of the year so far) and I didn't feel very hungry so I just had a cereal bar for breakfast
I carried on driving north;passed a couple of service stations as I still didn't feel like anything to eat, but thought I'd aim for Frankley Services

However, as I reached the south of Birmingham two things happened close together -

I felt a hypo coming on
There were warnings that the M5 was closed ahead, and that access to the M6 should be made by using the M42

I didn't fancy coming off the motorway and getting lost in Birmingham, so I thought I'd go onto the M42 and stop at Hopwood Services - big mistake
The hypo came on faster than I was used to, and before long I was drifting across a couple of lanes, and as there is now no hard shoulder I couldn't stop but at one point I drifted left off the inside lane and bounced off the kerb at the side of the motorway
My situation was not helped by the fact that about 95% of the motorway system now appears to be made up of roadworks
I looked for these emergency refuges (what we used to call lay-byes!) but never seemed to pass one; and that section doesn't have many exits.
By now I was sweating & panicking, so as the lesser evil I just slowed & stopped in the inside lane

As I expected and hoped a police car found me quite quickly. They took me & my car off to a side street to sort things out
I had some jelly babies and a choccy biscuit bar and gradually recovered
After they were satisfied I was OK they pointed out how to get onto the M6 and left, saying they would take no further action
I think they were impressed by the fact that I had a couple of packets of sweets in the glove compartment, and in the boot I had a record of my blood sugars, testing kit, and more food
They also agreed that the combination of roadworks & closures had made for unusual conditions, and that it was by no means the first time they had met motorists who had become trapped on Spaghetti Junction

I am surprised that I did not cause an accident, and I have learned a couple of lessons -
Be more careful about testing and eating, especially if I haven't eaten much beforehand
Get off a motorway asap if I feel a hypo coming on, and stop sooner rather than later

But there might be a problem in the future -
My driving licence is reviewed every 3 years, and I think there is a question along the lines of' have you had a hypo that requires assistance?'
I think I will have to inform them; so will that mean revoking my licence or a prolonged investigation, or will they accept the incident as a one off caused by exceptional circumstances?

That Stress always affects me & is not nice. Hope you are ok Zuludog

 

[zuludog]

As Bubbsie & Lisa66 have implied, perhaps I should let the matter rest, but I would like to give you an explanation

I've had diabetes treated with insulin for 20 years now, and have always tried to be sensible about it. It is well controlled, though if anything my BS tends to be towards the high side of acceptable
I've had a few hypos, mostly at home; a couple of times in the street, and once, as mentioned, while driving; but I've always managed to treat these myself. I've never before had a hypo whilst driving on a motorway and I stop at service stations for a rest, to eat, and to test. But as I came to the last services (Strensham) I felt fine, and I hadn't been driving that long, so I carried on
I usually get plenty of warning about a hypo, say 20 to 30 mins

On this occasion the weather was very hot, and the motorways were very busy.
As I turned from the M5 to the M42 I noticed the first signs of a hypo, but thought I would have the time to get to Hopwood Services. Remember that there are no hard shoulders now, just refuges, and I thought it would be safer to get to a service station. I did not think I was being irresponsible or taking a chance, this was a proper decision based on all my experience
Unfortunately the hypo came on much more quickly than I have ever experienced. I became confused, missed the services, and continued to deteriorate, but somehow I could not get onto a refuge, and as the situation became worse, I was forced to stop on the inside lane

As for not wanting to get off the motorway, yes, going into Birmingham was a consideration, but besides that, I didn't think it was so important, as I was confident I could get to Hopwood services without any difficulty

Yes, I realise it was a dangerous situation, and that I've had a narrow escape, but hindsight is a wonderful thing
I have contacted DVLA and they are sending me a report form, so we shall have to wait for the outcome
I have certainly learned a lesson

 

[Lucy Honeychurch]

I'm glad I don't drive as some days I wouldn't be able to go anywhere with hypos and hypers! Totally agree with @Robin and @Sprogladite about the irrationality of the hypo brain, my OH has found me wandering around the kitchen in a dazed state opening cupboards and drawers in the early hours looking for random things.
Sounds very frightening @zuludog, thankfully no one was hurt.

 

[HOBIE]

Life ? Its tough at the top 😉

 

[Diabetes UK]

@zuludog it sounds like it was quite a scary situation and must have shook you up once you had recovered from your hypo. It is good to hear that you are safe.

This discussion has caused some deliberation so thought I would offer some clarification on the matter.

The DVLA guidance is that "If you get warning symptoms of hypoglycaemia whilst driving, you must always stop as soon as safely possible."
The 'as soon as safely possible' part of that could be open to interpretation and judgment really. As you were in a situation where it was not immediately safe to pullover at the time, it would be acceptable that, with your knowledge of your own diabetes, you could wait for a safer place to stop. As the situation escalated quickly, you did pullover with the intention of treating the hypo.
This means (from the DVLA's perspective) you were aware of the signs and took steps to treat them. In an ideal situation, you would have pulled over sooner, but without a hard shoulder, this was a balance judgment of whether it's 'safer' to stop in the inside lane, or find a place to stop safely. When symptoms became more critical, you resorted to the next 'safest' option, which was to stop in the inside lane.

The DVLA state that a license should be revoked if you have had a 'disabling hypo' at the wheel. If the Police had found you in your car unconscious, or there had been an accident, then they would have likely considered it a disabling hypo. As they found you 'treating' it, they would not have considered this under the category of 'disabling hypo'.
You have been very fortunate and I am glad that this did not result in anything more serious. I am sure that this has been an experience that will mean that you act differently in managing future hypos due to the difference in the speed at which it came on.

In addition, as you have experienced a hypo quicker than usual, this may be something to share with your diabetes team. Your diabetes can change overtime and it may be something for you to review in case any hypos come on quicker in the future. You can also learn from this that it is important to have hypo treatments within easy reach when driving. However, even with hypo treatments in the car, you should still pullover to test and treat the hypo properly. Having sweets within reach may have just helped you in reaching a safer place to pull over.

It is understandable that there was concern about what the possible consequences were, and the incidents leading up to this, but as you mentioned, you made judgments based on your own experience of your own diabetes, and acted as best you could in order to remain safe.


In answer to your initial question - you would not have to disclose this as a 'severe hypo' to the DVLA as you were able to administer your own hypo treatment.
This would also unlikely be considered a 'disabling hypo at the wheel' again - as you pulled over. So, if you have safely pulled over, and treated your own hypo, then this would not be considered 'disabling'.

Hope that offers a little more guidance on the technicalities around how the DVLA and Emergency services assess these situations.

 

[zuludog]

HANNAH DUK - Thanks for your comments

As you might imagine this was a considerable shock to me, and I don't intend anything like this happening in the future
I am grateful and relieved that I did not cause an accident

I have contacted DVLA and they are sending me a report form. Obviously they could not give me an opinion or decision over the phone, but they gave the impression that this would be recorded, but that no action would be taken

The police officers were quite relaxed about this, and were impressed that I had sweets & other food available and that I was able to treat myself. Once they were satisfied that I had recovered they took no further action, and were happy to let me continue

I have made an appointment to see my DSN

 

[stephknits]

What is interesting to me is that those on insulin largely post with a feeling of 'there but for the grace of God go I'. This is how I felt when I read zuludog's honest post. Insulin requirements are often unpledictable, with one day very different from the next and one hypo very different from another. I have had one bad hypo while driving and did have jelly babies right in front of me. My hypo brain decided I was fine to finish my journey so that I could test before having my jelly babies. I had my kids in the car and still feel guilty years later. I think putting off dealing with your hypo is a very common symptom of hypo brain. Even though this happened and I am well aware that I tend to tell myself I can just finish whatever it is I am doing and thus look out for myself doing it, I can't honestly guarantee it wouldn't happen again. That does not make me a bad person or a bad decision maker.

 

[Northerner]

What is interesting to me is that those on insulin largely post with a feeling of 'there but for the grace of God go I'. This is how I felt when I read zuludog's honest post. Insulin requirements are often unpledictable, with one day very different from the next and one hypo very different from another. I have had one bad hypo while driving and did have jelly babies right in front of me. My hypo brain decided I was fine to finish my journey so that I could test before having my jelly babies. I had my kids in the car and still feel guilty years later. I think putting off dealing with your hypo is a very common symptom of hypo brain. Even though this happened and I am well aware that I tend to tell myself I can just finish whatever it is I am doing and thus look out for myself doing it, I can't honestly guarantee it wouldn't happen again. That does not make me a bad person or a bad decision maker.

Indeed I experienced one of my worst hypos whilst I was filling out a document (paper, not online). I was sweating profusely and shaking like a leaf, but I was determined to finish the document before testing. I finally gave in and tested - 1/9 mmol/l 😱 Needless to say I had to redo the document because it was just a series of indecipherable scrawls That was fairly early on after my diagnosis and I think it did teach me a lesson, but I have still been guilty of not acting quickly enough e.g. spending valuable time trying to pick out the right colour of jelly baby. Trivial in my case, as I don't drive and not placing others at risk, but living alone every possibility of leaving it too long and not waking up And whilst there may be people who are on insulin who might say they've never had this problem that's because we are incredibly complex and unique entities with many commonalities, but inevitably many differences.

 

[Lanny]

living alone every possibility of leaving it too long and not waking up

I’m terrified of that that too & I’m a bit scared of my lower BS figures these days! I had hypos in the past when still on novonorm tablets but, since being on insulin the hypos hit faster & harder! I have been slow to act during some of them & wasted time trying to finish things when they strike!

 

[Bubbsie]

Irrespective of how many explanations...excuses.. or defences are put forward...whether he should have stopped...whether he could have stopped... was he responsible or irresponsible the final arbiter on this matter will be the DVLA...I suspect the DVLA may contact the police who attended the incident … those officers will have made notes of their attention in this matter...possibly record any comments made by the driver...so I would caution the driver to bear that in mind when completing the incident report form...otherwise any discrepancies could result in far more serious consequences than a suspended licence.

 

[kentish maid]

the police who attended the incident … those officers will have made notes of their attention in this matter

I would imagine the police became aware of the incident through the use of CCTV footage. The new trend to do away with hard shoulders on motorways, and the introduction of so called 'Smart' motorways means that Comprehensive CCTV coverage is required. They may have footage of any erratic driving before the vehicle stopped

 

[Northerner]

Thread closed for further discussion. The matter has been reported and there is no need for further speculation here.