Driving with T1D requires extra responsibility, but millions of people do it safely every day. Learn the rules and habits that will keep you and others safe on the road.
Blood Sugar Requirements for Driving
The Golden Rule: Never Drive Low
Always check blood sugar before driving - no exceptions
Blood sugar should be at least 90 mg/dL (5 mmol/L) before starting
If below 90, treat and wait 15 minutes, then recheck
Pull over immediately if you feel low while driving
Wait at least 45 minutes after treating a low before driving
Managing Highs While Driving
High blood sugar is safer than low for driving, but still problematic
Above 250 mg/dL: check for ketones before long drives
Very high blood sugar can affect focus and reaction time
Take correction insulin but give it time to work before driving
Stay hydrated to help manage highs
During the Drive
Check blood sugar every 2 hours on long trips
Set CGM alerts louder when driving so you never miss them
Keep fast-acting glucose in easy reach (cup holder, door pocket)
On CGMs showing arrows: down arrows mean pull over and check
Never try to "make it" to your destination if you're dropping
DMV Regulations and T1D Disclosure
License Application Requirements
Most states require disclosure of diabetes on license applications
You may need a letter from your endocrinologist confirming you can drive safely
Some states require annual medical reviews - check your state's requirements
Commercial driver's licenses (CDL) have stricter federal requirements
Lying on applications can result in license suspension
What Your Doctor Will Need to Verify
You recognize hypoglycemia symptoms and treat appropriately
Your A1C and blood sugar management are reasonable
You haven't had severe hypoglycemia requiring assistance recently
You understand driving safety requirements with T1D
You have no diabetes-related complications affecting driving ability
Your Rights as a Driver with T1D
You cannot be denied a license solely because you have T1D
Individualized assessment is required - not blanket restrictions
You can appeal medical reviews and restrictions
Discrimination based on diabetes alone is illegal under ADA
Contact diabetes advocacy groups if you face unfair treatment
Emergency Supplies for the Car
Essential In-Car Diabetes Kit
Fast-acting glucose: tabs, juice boxes, or glucose gel (multiple servings)
Blood glucose meter with extra test strips and lancets
Emergency contact card with diabetes information
Medical ID visible from driver's seat (on keys or visor)