DVLA asking for views on policy changes

[Lucyr]

Are you pushing back because you intrinsically (and naively) trust everyone to do the right thing? because you’re on such medication and don’t want to test to drive or do you have some other reason to want less road safety?

Because there is no legal requirement to test before driving if on tablets, that’s clear enough to me but many on this forum scare those on tablets that can cause hypos into thinking they have to test before driving a car. They don’t, they might choose to, they might use it as a reason to ask their GP for more test strips, but ultimately they can legally drive without testing on tablets and if they can’t get prescribed or personally afford test strips they don’t need to stop driving.

Of course personally I always test before driving, I take 5/6 injections of insulin a day and have signed to say that I will test before driving. I don’t drive much because of my ME (which I don’t even have to tell the DVLA about).

 

[Dragonheart]

Because there is no legal requirement to test before driving if on tablets, that’s clear enough to me but many on this forum scare those on tablets that can cause hypos into thinking they have to test before driving a car. They don’t, they might choose to, they might use it as a reason to ask their GP for more test strips, but ultimately they can legally drive without testing on tablets and if they can’t get prescribed or personally afford test strips they don’t need to stop driving.

Of course personally I always test before driving, I take 5/6 injections of insulin a day and have signed to say that I will test before driving. I don’t drive much because of my ME (which I don’t even have to tell the DVLA about).

But it isn’t clear to others if you read beyond the inf188/2 leaflet you are relying on. It not just me that thinks it’s unclear or that you do need to test. The subject comes up repeatedly on lots of sites. It needs clarification. The fact that we are arguing about it proves that.

 

[Lucyr]

It needs clarification

I’ve already clarified for you? Anyone trying to fill in the form notifying dvla of diabetes on tablets would see at the top it’s just for those on insulin too, can’t see how it needs to be any clearer.

 

[Robin]

But it isn’t clear to others if you read beyond the inf188/2 leaflet you are relying on. It not just me that thinks it’s unclear or that you do need to test. The subject comes up repeatedly on lots of sites. It needs clarification. The fact that we are arguing about it proves that.

I’ve already clarified for you? Anyone trying to fill in the form notifying dvla of diabetes on tablets would see at the top it’s just for those on insulin too, can’t see how it needs to be any clearer.

This is exactly what’s being asked.What clarification needs to be made? If it’s the case now that the wording of the guidance says people on potentially hypo-inducing meds don’t need to test (and I remember debating this in another thread and being shocked to learn from Lucyr that the latest wording suggested you didn’t need to test) then this is something that needs tightening up.
The other thing is, when the wording for the 'general public' says that 'your doctor or HCP will tell you if you need to test' it assumes that the 'guidance for doctors' leaflet is explicit, and I'm not sure it is. Or doctors don’t read it, we have had members quoting what they’ve been told by their GP, which doesn’t accord with the wording.

 

[Dragonheart]

I’ve already clarified for you? Anyone trying to fill in the form notifying dvla of diabetes on tablets would see at the top it’s just for those on insulin too, can’t see how it needs to be any clearer.

I don’t want clarification from you (who is not an expert on the law, driving or dvla as far as I’m aware or can see based on your posts) as I disagree with your assessment. I want it from dvla who after all are the authority.

And for the last time the issue is NOT about notifying them of the medication (I know you don’t need to and have never claimed otherwise), but about testing whilst on a hypoglycaemic drug that may affect fitness to drive and safety. Your inability to grasp that repeated and fundamental point makes me question your comprehension of the matter even more.

 

[Dragonheart]

This is exactly what’s being asked.What clarification needs to be made? If it’s the case now that the wording of the guidance says people on potentially hypo-inducing meds don’t need to test (and I remember debating this in another thread and being shocked to learn from Lucyr that the latest wording suggested you didn’t need to test) then this is something that needs tightening up.
The other thing is, when the wording for the 'general public' says that 'your doctor or HCP will tell you if you need to test' it assumes that the 'guidance for doctors' leaflet is explicit, and I'm not sure it is. Or doctors don’t read it, we have had members quoting what they’ve been told by their GP, which doesn’t accord with the wording.

In the leaflet being referred to https://assets.publishing.service.g...vers-with-diabetes-treated-by-non-insulin.pdf it doesn’t actually say you don’t need to test. It simply doesn’t say you do. It does say “In the interests of road safety, you must be sure that you can safely control a vehicle at all times.” having discussed hypos. The leaflet covers all non insulin medication not just hypoglycaemic ones and the rules are not the same for them all as can be seen by the drs guidance. It is mostly covering the need to notify DVLA re medications.

The guidance for drs is very clear and makes it a requirement in order to drive without notifying DVLA
https://assets.publishing.service.g...84397/assessing-fitness-to-drive-may-2022.pdf says with regards to sulphonylureas and glinides on page 78. Appendix D is the leaflet above

“May drive and need not notify DVLA, provided:
■ no more than 1 episode of severe hypoglycaemia while awake in the last 12 months and the most recent episode occurred more than 3 months ago
■ should practise appropriate glucose monitoring at times relevant to driving
■ under regular review
It is appropriate to offer self monitoring of blood glucose at times relevant to driving to enable the detection of hypoglycaemia.

If the above requirements and those set out in Appendix D (page 127) are met, DVLA need not be informed.”

I fail to see how the comparison between the lack of detail in the public leaflet compared to the very clear and specific requirements in the drs guidance is seen as anything other than needing official clarity. The advice and requirements need to be consistent.

This NHS document says you need to test. https://publicdocuments.sth.nhs.uk/pil3371.pdf on page 5
This GP notebook says both the requirements posted above AND those in INF188/2 need to be met in order to drive without informing DVLA https://gpnotebook.com/en-gb/simplepage.cfm?ID=x20190625121556181497

edit to add : I’ve suggested to the mods we move this discussion to it’s own thread with a link left here to save derailing.

 

[Lucyr]

This NHS document says you need to test. https://publicdocuments.sth.nhs.uk/pil3371.pdf on page 5

That’s an old document, not been reviewed for 3 years. You used to have to test on tablets that can cause hypos, you don’t any more as dvla guidance changed.

 

[Dragonheart]

That’s an old document, not been reviewed for 3 years. You used to have to test on tablets that can cause hypos, you don’t any more as dvla guidance changed.

That document (Nov 2020) states the same as the more recent .gov one dated May 2022. Ie testing is required.

I’m aware that the method of testing changed a few years ago (Feb 2019?) to allow flash gm and cgm rather than just fingerpricks. There was also a change (Jan 2018?) about when a licence can be revoked after severe hypos (from anytime to awake). Both of these changes were before the linked documents were issued.

Can you demonstrate or link to anything that shows the requirement to test on specific tablets changed?

 

[Dragonheart]

The current .gov page (June 2022) also says the same thing. https://www.gov.uk/guidance/diabete...etes-treated-by-medication-other-than-insulin


The problem here is that the INF188/2 leaflet is not comprehensive of the rules. Yourself and others, including drs, are relying solely on that single document and giving incorrect or incomplete advice which might result in illegal and dangerous actions.

 

[trophywench]

Well Lucy - now they ARE reviewing it and have hence asked people who the guidance happens to affect, what they think it ought to say. The main difficulty with ANY thing written is that different people interpret the different words according to their own personal agenda. This is exactly why Legal documents - and insurance policies - must be written with absolutely NO punctuation whatever, to try and negate any misinterpretation.

More than several times this very day we've been appalled at the lack of roadcraft of numerous drivers on the roads we needed to travel. Misty morning just after 8am - M6 (and before and after) many vehicles were showing no lights to the rear - yet most of em had their daylight running lights on at the front when we were able to see their front. No use whatever if someone runs up the back of you cos they didn't notice you were there! Changing lanes/directions without indicating. Driving down a main road with various side road crossroads - traffic jam - when we came along there the opposite way, we knew there were roadworks the other end, so OK, we can wait. So we didn't block the next side road and a van driver was thus able to cross the main rd into the other road opposite and plainly from the mime he delivered to us he said 'Thank you!' and 'Why the hell do people deliberately block others from going about their business?' Beats us, Same as Messrs Must get in front of everybody cos I HAVE to get there before anybody else. Er, why is that exactly????

What with that and also often wondering whether some drivers ever actually took a driving test let alone passed it - the chances of someone having a hypo whilst at the wheel seem to reduce a bit.

 

[Lucyr]

This is exactly why Legal documents - and insurance policies - must be written with absolutely NO punctuation whatever, to try and negate any misinterpretation.

Not sure where you get this information from. Just renewed my policy and there’s plenty of punctuation.

 

[trophywench]

I expect it is because I am far more used to the wording of Legal Liability insurance policies than any other classes of insurances.

 

[everydayupsanddowns]

because you’re on such medication and don’t want to test to drive?

Lucy takes insulin, so I think it’s just a difference of opinion on the clarity of materials.

 

[everydayupsanddowns]

If you are hypo you are not safe. How else can a person on hypoglycaemic medication be sure they are not hypo other than by testing? Especially if they have any symptoms whatsoever, have lost hypo awareness or are new to the medication?

The DVLA are pretty clear that it is your own hypo warning signs that you need to be able to use to evaluate hypos.

If you are hypo unaware you need to stop driving and inform them.

You aren’t allowed to drive and only use CGM alarms to alert you to hypos. You have to be able to recognise them yourself.

As far as I can see the requirements around testing before and during driving is more to be able to provide evidence that your BG was in a good range if you ever need it?

 

[Lucyr]

That document (Nov 2020) states the same as the more recent .gov one dated May 2022. Ie testing is required.

I’m aware that the method of testing changed a few years ago (Feb 2019?) to allow flash gm and cgm rather than just fingerpricks. There was also a change (Jan 2018?) about when a licence can be revoked after severe hypos (from anytime to awake). Both of these changes were before the linked documents were issued.

Can you demonstrate or link to anything that shows the requirement to test on specific tablets changed?

There have been other changes over time too. You used to have to inform the dvla If you took tablets like gliclazide, you don’t any more.

Just test before driving if it makes you feel better, it’s not necessary for a car licence unless on insulin, and if you can’t tell your hypo without testing then you need to lose your licence anyway, but extra testing won’t do any harm. Or ask your Dr whether you should test and go with their answer, that’s what the DUK site advises which seems fair because the dr should then prescribe test strips if they advise to test.

 

[Dragonheart]

The DVLA are pretty clear that it is your own hypo warning signs that you need to be able to use to evaluate hypos.

If you are hypo unaware you need to stop driving and inform them.

You aren’t allowed to drive and only use CGM alarms to alert you to hypos. You have to be able to recognise them yourself.

As far as I can see the requirements around testing before and during driving is more to be able to provide evidence that your BG was in a good range if you ever need it?

Not everyone new to medication will have a clue that what they are feeling is a hypo, or even that glic can cause them (they should be but let’s be real) . Nor is everyone aware they are unaware if you get my meaning. I never suggested meters or cgm replace awareness. The requirement isn’t just to cover your *** after an incident - it’s mostly to prevent the incident

 

[Robin]

The whole area of driving and being on a potentially glucose lowering med looks like it could do with consistency and clearer wording. The guidance for motorists may no longer require testing, but the guidance for doctors is still wish washy.

What is meant by 'Appropriate' What 'times' are 'relevant to driving' ? This is virtually meaningless, and could be interpreted differently by different doctors. (and has been, as we’ve seen on threads started by confused Newbies)

Diabetes mellitus: assessing fitness to drive

Advice for medical professionals to follow when assessing drivers with diabetes mellitus.

www.gov.uk

 

[Robin]

Not everyone new to medication will have a clue that what they are feeling is a hypo, or even that glic can cause them (they should be but let’s be real) . Nor is everyone aware they are unaware if you get my meaning. I never suggested meters or cgm replace awareness. The requirement isn’t just to cover your *** after an incident - it’s mostly to prevent the incident

That’s something where testing would be 'appropriate' As you say, when you’re first put on glucose lowering meds, how do you know what a hypo feels like til you’ve had one, and are sure it wasn’t just that you were feeling faint because you were hungry, etc, unless you can check on a meter at the times when you feel 'off' until you’ve learnt what your own personal hypo symptoms feel like. I know that when I had my first hypo on insulin, it wasn’t anything like the 'classic' signs that I'd read about in the leaflets. (they normally say 'sweaty and shaky' which is only what I feel as I'm recovering, my first signs are clumsiness and tripping over words). If I didn’t have a meter to check against, how would I have known that they were 'my' symptoms?

 

[Dragonheart]

There have been other changes over time too. You used to have to inform the dvla If you took tablets like gliclazide, you don’t any more.

Just test before driving if it makes you feel better, it’s not necessary for a car licence unless on insulin, and if you can’t tell your hypo without testing then you need to lose your licence anyway, but extra testing won’t do any harm. Or ask your Dr whether you should test and go with their answer, that’s what the DUK site advises which seems fair because the dr should then prescribe test strips if they advise to test.

I never suggested they were the only two changes. I did ask if you could demonstrate when the change re taking glic happened. I haven’t found it yet so I’m assuming at this point quite some time ago and before the guidance links I posted were issued.

Personally I’m not on any medication so I don’t need to test. I’m trying to help people be safe and legal and avoid accidents in the face of confusion caused by one leaflet and lots of misinformation. And you keep saying it’s not necessary despite the documents saying it is. Are you ignoring them entirely? What other than that one leaflet, that says nothing of testing, makes you so sure you’re right? Even if you are right, which I don’t believe you are, then the fact that this debate happens over and over again proves there’s confusion and it needs more clarity.

Yes a dr should know the correct answer if they follow their guidance documents (as linked - which are very clear). We could do a survey in here of glic users and see how many drivers were told at the time they were initially prescribed about hypos (I fear it’s not 100%) the need to test (I’m confident it’s not 100%) and given the kit to do so (probably in between the two)

 

[Dragonheart]

What is meant by 'Appropriate' What 'times' are 'relevant to driving' ?

It defines it in the column right next to the circled one. Yes it should say it in both.

(I’m not confused, nor a newbie to diabetes or forums, just not actually joined this one til recently)