Many people with type 1 diabetes get their driver’s licenses and drive safely every day. However, please remember that your driving can be affected by low blood sugar (hypoglycemia). Driving with low blood sugar can raise the risk of injury to yourself and others. Low blood sugar can be a cause of accidents in drivers with diabetes. Because of the effects of low blood sugar on a driver’s abilities, it has even been compared to driving drunk in terms of its level of danger.
That’s why it is important to take steps to prevent low blood sugar before getting in the car. It’s also critical to know what to do if you start to feel that you have low blood sugar while driving.
For questions about driving safely with type 1 diabetes, please speak with your diabetes care team.
Why driving with low blood sugar is not a good idea
People with low blood sugar may have trouble focusing on the road, a hard time seeing clearly, and slower reactions to hazards on the road. Severe low blood sugar can be life-threatening whether you are driving or not. Please remember to check blood sugar often.
Preparing for a car trip
Here are some important things to double-check before getting into a car:
- Your driver’s license and medical ID bracelet or necklace
- Charged cell phone
- Snacks and supplies, such as fast-acting carbohydrates, juice, crackers, insulin, and a meter
- Check blood sugar before getting into the car
- Drive if your blood sugar is not in the target range. Confirm what your target range should be with your health care provider. Recommendations for this vary, but generally your blood sugar should be no lower than 90 mg/dL
- Drink alcohol. It is illegal to drink and drive. Also, drinking even small amounts of alcohol before driving puts you at an even greater risk for having a car accident. Alcohol can make low blood sugar worse. This may also make driving harder as well as riskier. Alcohol increases the risk of low blood sugar for up to 24 hours after drinking, so talk to your health care provider about whether drinking any alcohol is safe for you, whether or not you’re driving
Dealing with low blood sugar while behind the wheel
- Pay attention to physical signs. If you have symptoms of low blood sugar, such as hunger, shakiness, sweating, confusion, or weakness, pull over immediately
- Do a blood sugar check. If blood sugar is low, treat with fast-acting carbohydrates. Wait 15 minutes and then check it again
- Do not start driving again until blood sugar is in the target range (generally at 90 mg/dL or above)
- When taking a long car trip, stop often for blood sugar checks and eat snacks as needed to keep blood sugar at 90 mg/dL or above. Tell your family and friends when you need to pull off the road and take care of these issues—even if it causes a delay. Most people will understand and value safety over being on time!
For teens and new drivers
Compared to drivers in other age groups, teenagers between the ages of 16 and 19 have the highest risk of car accidents. When this risk is added to the effects of diabetes and low blood sugar, it can be even more dangerous. So here are a few extra words of caution to help young drivers travel safely:
- Never do a blood sugar check while driving a moving vehicle. Pull over someplace safe if you need to check
- Avoid alcohol. Remember, underage drinking is illegal. Do not drink alcohol, especially when planning to drive
- Eating while driving should be avoided
- States’ graduated driver’s license (GDL) laws should be followed where they apply
- Seat belts should be worn on every trip
- Nighttime driving should be limited
- The number of teen passengers should also be limited
- Don’t ever use a cell phone or text while driving
- Drive within speed limits
When preparing for a road trip, it helps to get everything in order by making a travel checklist with all your major items before you go. Learning how to check blood sugar on the road and making healthy food choices when eating out are also important. An easy-to-follow activity plan can help people with type 1 diabetes stay active while traveling.
Leave plenty of time to plan so you will be able to focus on having fun on your road trip, and not on all the details. This “to-do” list is actually a “must-do” list.
- Have a list of emergency phone numbers
- Have a health insurance card available at all times
- Ask a doctor for a note stating why there’s a need to travel with diabetes supplies
- Talk to a doctor about any insulin schedule changes
- Get all required vaccinations
- Get emergency prescriptions from your health care provider
- Bring all other daily medications
- Have the name and address of a hospital in the travel area
- Carry a few names of English-speaking doctors to contact if traveling out of the country. Ask a doctor for help finding them. Or, call a local medical school in the area you will be in for a list of English-speaking doctors, too
- Insulin (pens and needles, or vials and syringes)
- Test strips
- Pump (if you use one, and any additional pump supplies)
- Extra glucose (blood sugar) monitors
- Glucose tablets and any other supplies to treat low blood sugar
- Glucagon emergency medicine (if prescribed)
- Alcohol swabs
- Footwear that fits well
Be sure to check the expiration dates of all items that have them, so they won’t fail on the road. Also check and follow storage instructions on all your supplies and medicines.
Get a helpful travel checklist from the JDRF.
When it comes to testing while traveling, keeping it simple is best:
- Prepare for possible changes in insulin dosage. A big trip, and the excitement that surrounds it, may cause low blood sugar, so consult with your doctor for help with adjusting insulin doses at these times. Having a written copy of your care plan with you and having a spare insulin prescription in case of an emergency might be a good idea, too
- Prepare to test more often. Even if a doctor directs you to test at least 6 times a day during a regular routine, testing more often may be necessary when traveling. Three factors that can greatly affect blood sugar are heat, excitement, and stress
- Carry water at all times. Being thirsty (not having enough fluids) is not good for anyone, and for someone with type 1 diabetes, being very hot can create the need for more water (or other fluids). Most experts say you should have at least eight 8-oz. glasses a day, and more when you’re more active
- Protect supplies. Make sure all insulin, meters, test strips, and other supplies stay out of direct sunlight. However, when storing, avoid extreme heat as well as extreme cold. If you use a cooler or cold pack to carry medicines, be sure your insulin never freezes. Be very aware of both hot and cold temperatures during travel
When trying to match healthy habits at home with eating on the road, many people are not sure what to do. A good rule of thumb for what to eat on the road can be found in the new food plate guidelines from the American Diabetes Association. That will provide a general idea of the balance of foods you should eat each day, which can be tailored for the specific needs of people with type 1 diabetes. Check with your doctor to find out what he or she wants you to do. If you or your loved one takes certain diabetes medicines, following a regular schedule is best. Here are more tips that can help.
Check online tools and keep healthy tips in mind
- Know food values ahead of time. Many restaurant menus are high in fat and calories, so it’s good to check the numbers before you go. Many fast food restaurants post food guidelines of their menus on the Internet. To find the protein, fat, and carbohydrate values of food, use a good calorie counter. This can help take the mystery out of eating out. And, if the menu really is too unhealthy, drive right by it and stop at the next one. Talk with your doctor about how many meals and snacks you should eat each day for steady blood sugar
- Eat balanced portions. If the serving size is too large, share some with a dining partner, take the leftover food to go, or just leave it behind
- Watch the amount of high-fat foods you eat. These, along with sweets, are not the best for managing type 1 diabetes. Limiting them will help you keep your blood sugar and blood fats under control
- Ask to swap for healthier foods. Instead of French fries, request a double order of vegetables, or ask that the high-fat food be omitted
- If your blood sugar is low, try 1/2 cup of fruit juice, 1 cup of milk, or a tablespoon of honey to help stabilize it
- If traveling outside of the United States and wondering how other countries compare to the diet a doctor has given you, find out about dietary guidelines from around the world to see how other countries where you may be traveling handle nutrition. That way, you’ll know what to find and how to adapt if you’re visiting. If shopping in a market, see if properly labeled US brands can be found. When you can, try to make sure your meals have whole grains, fruits, vegetables, and lean protein, with a side of dairy once in a while
- Research local restaurants ahead of time for fun places. Try Thai, Mexican, or Italian restaurants, for example. Just check the nutritional values of their dishes to make sure they have healthy options you can enjoy
- Finally, carry a list of any foods your doctor suggests that you not take with your medicine. Remember, what and when you eat can affect how your diabetes medicines work
Don’t know what’s in it? Then don’t drink it!
Traveling to new places means you’ll see tempting local drinks on the menu. Before you order, you need to know exactly what is in that drink. And if it has alcohol in it, the safest answer is, “No, thanks.” Alcohol can have an immediate effect on your blood sugar, and even keep you from properly treating yourself.
Keeping it moving on the road
You still need to be physically active when traveling. For example:
- Move around every few hours to get your circulation going
- Try finding a hotel with a gym. When making reservations, ask if gym access is offered. If you are new to the machines in this gym, go slow and take care during your exercise
Always check with your health care provider about the types of physical activity that are right for you.