From the Guidelines
A driver's medical template should include a comprehensive assessment of the individual's medical history, including diabetes, to determine their fitness to operate a vehicle safely. When evaluating a driver's medical fitness, it is essential to consider the potential risks associated with diabetes, such as hypoglycemia, and its impact on driving ability 1. The template should include sections for personal information, medical history, vision assessment, cardiovascular health, neurological conditions, substance use, medications, and a physician's certification.
The evaluation process should involve a thorough assessment of the driver's medical history, including any episodes of hypoglycemia, loss of consciousness, or other conditions that may impair driving ability 1. A short questionnaire can be used to identify potentially at-risk drivers, asking about episodes of hypoglycemia, loss of visual acuity or peripheral vision, and loss of feeling in the right foot 1. The questionnaire should also query about obstructive sleep apnea, which is more common in people with type 2 diabetes, and ask about falling asleep during the day 1.
It is crucial to note that a history of hypoglycemia does not necessarily mean an individual cannot be a safe driver, and licensing decisions should take into consideration contributory factors that may mitigate a potential risk 1. The evaluation should be undertaken by the treating physician or another diabetes specialist who can review recent diabetes history and provide a recommendation about whether the driver has a condition that impairs their ability to safely operate a motor vehicle 1.
When implementing a driver's medical template, it is essential to ensure compliance with local transportation authority requirements, as standards vary by jurisdiction 1. Medical professionals should document any conditions requiring medication that might affect driving, such as antihistamines, benzodiazepines, or opioids, noting dosages and potential side effects. Regular updates to the template are necessary as medical conditions and treatments change over time.
From the Research
Drivers Medical Template
- The Assessment of Driving-Related Skills (ADReS) is a clinical tool used to identify potentially unsafe older drivers, which includes tests of vision, motor function, and cognition 2.
- The ADReS has limited utility as an office screen for individuals who should undergo formal driving assessment, with a sensitivity of 0.81 and a specificity of 0.32 2.
- Improved scoring methods and screening tests with greater diagnostic accuracy than the ADReS are needed for general office practice 2.
Medical Conditions and Driving
- Epilepsy is a condition that can affect driving ability, with approximately 1 in 26 people in the United States affected by the condition 3.
- Cardiovascular disease risk is increased in individuals with epilepsy, with a 52% increase in atherosclerotic cardiovascular disease (ASCVD) risk 4.
- Visual acuity is correlated with ischemia and neurodegeneration in patients with early stages of diabetic retinopathy, which can affect driving ability 5.
Visual Sensitivity and Driving
- Visually sensitive seizures can be provoked by light flashes, patterns, or color changes, with a prevalence of up to 1 in 4000 persons 6.
- Photosensitive seizures are more common in the young and in specific forms of generalized epilepsy, and can be triggered by video games, social media clips, and other visual stimuli 6.
- Prevention of visually induced seizures includes avoiding provocative stimuli, covering one eye, wearing dark glasses, and taking certain antiseizure drugs 6.