# driving as pumpers?



## heasandford (Feb 10, 2011)

Just a quick question - in light of the criteria for obtaining a pump, were any (or all??) of you disqualified from driving having had hypo unawareness? If not, how does the criterion stand?


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## Liz! (Feb 10, 2011)

Pump or not, you must tell the DVLA yourself that you have hypo unawareness, it's not up to your Dr, it's up to you. If you do have hypo unawareness, you are not allowed to drive, and what's more, if you don't tell them and give up your license your insurance is not valid.


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## novorapidboi26 (Feb 10, 2011)

For the people that do get unawareness.......surely it doesn't last long enough to warrant telling the dvla......just cut your insulin....probably not as simple as that...


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## Liz! (Feb 10, 2011)

It's not. It's illegal to drive if you have hypo unawarenss until you have your symptoms back. you Have to tell the DVLA. 

What if you hit a child? Mounted the pavement?


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## Robster65 (Feb 10, 2011)

I would guess most drivers would ensure they are at something like 7 or 8 before driving and then test frequently in case they drop. I agree it is fraught with danger but I would imagine there's plenty who manage it on the quiet rather than lose their licence.

Rob


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## Liz! (Feb 10, 2011)

Then they are evil. Hypo unawareness can strike at any time. I know someone who mounted the pavement. It's simply unforgivable.


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## heasandford (Feb 10, 2011)

ooh sorry, yes I agree, just wanted to know how you could have a pump unless you were already hypo unaware


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## Liz! (Feb 10, 2011)

It doesn't depend on unawareness. I think you can if your control is very hard to get right. For instance, i was always hypo in the afternoon and quite often at night - didn't seem to be able to get it right at all whenever put my long acting insulin, and whichever insulin it was. When I got the pump i found out that my inulin requirements are very differnt through the day and night, and always very, very low in the afternoon. in fact almost zero for an houtr or so. No long acting insulin can replicate those needs.

With the pump it's much easier.


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## Copepod (Feb 10, 2011)

novorapidboi26 said:


> For the people that do get unawareness.......surely it doesn't last long enough to warrant telling the dvla......just cut your insulin....probably not as simple as that...



DVLA doesn't give any guidance (that I can see) about how long hypo awareness must continue before you inform them. However, everyone must follow recommendations to test blood glucose before setting off and every 2 hours, and not drive if level is 4.0mmol/ or lower.  

The general advice from professionals is a bit more than "just cut your insulin" - more likely to recommend running levels a bit higher to try to regain hypo awareness.

Glad Heasandford finally got an answer to question - must admit I didn't really understand what they were asking to start with.


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## bev (Feb 10, 2011)

Hi all,
I dont understand the connection between driving and being on a pump and hypo unawareness.Bev


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## Jennywren (Feb 10, 2011)

I have had hypo unawareness for years so cant drive but get a free bus pass as i have trouble with eyes as well


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## Liz! (Feb 10, 2011)

If you are aplying for a license, you MUSt report any hypo unawareness on the form, and if you do, you don't get the license, it also states that if you are diabetic, if at any point you experience unawareness, you must report it immediately. At that point your license will be taken from you.

"If you suffer from hypo unawareness, that is you have difficulty recognising hypo warning symptoms, the DVLA states that you should not drive.

If hypo awareness recovers, you may resume driving but the recovery of hypoglycaemia awareness must be confirmed by a consultant or GP."

It is your responsibility to do this and if you carry on driving, asi said above you will be uninsured.


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## Ellie Jones (Feb 10, 2011)

Bit confused about what you are actually asking, but my take on it you are asking about pumps and driving!

You don't have to inform the DVLA concerning going onto the pump, as you'll not changing the medication regime only the delivery system..  But it is wise to be extremely cautious about driving when you first go onto the pump, with a lot of extra testing...

If you are thinking of claiming hypo unawareness to gain a pump and you drive think very carefully, as your consultant is likely to advise you to stop driving, he's not legally bound to inform the DVLA that he's advised you of this, as this is your responcability, but however if you have any form of accident it will be written on your medical files!

On the subject of accidents, if you are involved in one and the police are called etc..  They will go through your control with a fine tooth combe, so it pays to ensure that we taken all the procautions we can to ensure that we can prove when we sat behind the wheel of our car to undertake our journey!


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## novorapidboi26 (Feb 10, 2011)

I agree that if you cant tell when a hypo is coming on you shouldnt be allowed to drive, I was trying to get a discussion going on 'hypo unawareness' and how long it can last, because with my undertsanding going hypo regularly and therefore losing the ability to recognise low blood sugar is the result of too much insulin...........

jenny, you say you have been unaware for years, really? thats must be really bad, what has been done to combat this......i know your on a pump now......

also when I said 'cut your insulin' that was meant to mean run at high levels till you get the symptoms back......the majority of folk know that..........


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## Robster65 (Feb 10, 2011)

I'm guessing the question was about a common criterion for going on a pump being hypo unawareness.

And if you meet the this criterion, should you not also inform DVLA so that they can 'review' your ability to drive.

ie. if you meet this particular criterion, you should also not be driving. Which could be a bit of a catch 22 for someone who relies on their car but also wants to gain better control. And a lot of people do rely on their car through a lack of public transport. So they may choose not to go the pump in case they have to admit hypo unawareness and the DVLA get told.

I think. 

Rob


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## heasandford (Feb 10, 2011)

think this answers my question - it seems to me a catch 22 as well. Didn't mean to confuse, but everything I'd read about getting a pump seemed to include hypo unawareness. Not sure whether a pump would help with my erratic results but thinking about it.


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## Liz! (Feb 11, 2011)

I'm sure it would heasandford. 

Running at higher levels or going onto animal insulin CAN help regain hypo awareness - but not necessarily. I have done both, and still remain totally unawatre.


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## Ellie Jones (Feb 11, 2011)

I've been reading your other post on the general board..

And what you'll saying over there I think that an insulin pump would help you out indeed..

As from what you saying there, a lot of your problems could be around your basal profile not being able to flat them out enough to make a good working profile with injecting background insulin once or twice a day...   With the pump you can adjust the level of insulin on the basa by the hour, better matching your actual needs producing a lot flatter working basal profile..

And there is so much more you are able to do with the bolus settings etc, it can be used pro-actively and reactively..


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## Ergates (Feb 11, 2011)

The thought of someone quite happily driving away on the quiet whilst having hypo unawareness is horrifying.  I'd shop them in a heartbeat, it's even more irresponsible than drink driving IMO.


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## novorapidboi26 (Feb 11, 2011)

* A recent history of frequent low blood sugars
    * A rapid drop in blood sugar
    * Having diabetes for many years
    * Stress or depression
    * Situations where self-care is a low priority
    * Alcohol consumption in the last 12 hours
    * A previous low blood sugar in the last 24 to 48 hours
    * Use of certain medications like beta blockers

The above are reasons for unawareness occurring ,taken from a Google search........so it looks like running high for a week or two might not be enough for some folk...........gutted..........


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## Liz! (Feb 11, 2011)

It's not a week or two anyway novorapidboi, it's about 3 months.


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## novorapidboi26 (Feb 11, 2011)

Liz! said:


> It's not a week or two anyway novorapidboi, it's about 3 months.




Research has shown that people who have hypoglycemia unawareness can become aware again of low blood sugars by avoiding frequent lows. Preventing all lows for *two weeks* resulted in increased symptoms of a low blood sugar and a return to nearly normal symptoms after *3 months*.

For more info, visit: http://www.diabetesnet.com/diabetes_control_tips/hypoglycemia_unawareness.php#ixzz1DdtBKaUs

Were both right..........yay....

Obviously with all the other factors I mentioned earlier these normal behaviours may not apply to some people.......which to me is really scary, I would sooner walkabout high than risk collapsing several times a day.....


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