From the Research
A Department of Transportation (DOT) driver with glucosuria but no diabetes diagnosis can typically be certified for up to 2 years, which is the maximum certification period for any commercial driver. For this certification to be granted, the driver must undergo appropriate medical evaluation to confirm that the glucosuria is not indicative of diabetes mellitus. This evaluation should include fasting blood glucose and hemoglobin A1C testing to rule out diabetes, as suggested by studies such as 1. If these tests are normal (fasting glucose <126 mg/dL and A1C <6.5%), the medical examiner can issue the standard 2-year certification. The driver should be advised to follow up with their primary care physician to determine the cause of the glucosuria, as it could be benign renal glucosuria (a harmless condition where the kidneys excrete glucose despite normal blood glucose levels) or an early sign of developing metabolic issues. Annual monitoring of blood glucose levels is recommended even with a 2-year certification to ensure diabetes does not develop during the certification period, as undiagnosed or poorly controlled diabetes could affect driving safety through symptoms like hypoglycemia, vision changes, or neuropathy, as highlighted in studies like 2 and 3. Key considerations for the medical evaluation and certification process include:
- Fasting blood glucose and hemoglobin A1C testing to rule out diabetes
- Normal test results (fasting glucose <126 mg/dL and A1C <6.5%) for standard 2-year certification
- Annual monitoring of blood glucose levels to prevent undiagnosed diabetes
- Potential risks of undiagnosed or poorly controlled diabetes on driving safety, as discussed in 4 and 5.