Driving with type 1 diabetes: real-world evidence to support starting glucose level and frequency of monitoring during journeys

Steven Trawley, Amanda N. Stephens, Sybil A. McAuley, Jane Speight, Christel Hendrieckx, Sara Vogrin, Melissa H. Lee, Barbora Paldus, Leon A. Bach, Morton G. Burt, Neale D. Cohen, Peter G. Colman, Elizabeth A. Davis, D. Jane Holmes-Walker, Alicia J. Jenkins, Joey Kaye, Anthony C. Keech, Kavita Kumareswaran, Richard J. MacIsaac, Roland W. McCallumCatriona M. Sims, Stephen N. Stranks, Vijaya Sundararajan, Glenn M. Ward, Timothy W. Jones, David N. O'Neal

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1 Citation (Scopus)


There is limited evidence supporting the recommendation that drivers with insulin-treated diabetes need to start journeys with glucose >90 mg/dL. Glucose levels of drivers with type 1 diabetes were monitored for 3 weeks using masked continuous glucose monitoring (CGM). Eighteen drivers (median [IQR] age 40 [35, 51] years; 11 men) undertook 475 trips (duration 15 [13, 21] min). Hypoglycemia did not occur in any trip starting with glucose >90 mg/dL (92%; n = 436). Thirteen drivers recorded at least one trip (total n = 39) starting with glucose <90 mg/dL. Among these, driving glucose was <70 mg/dL in five drivers (38%) during 10 trips (26%). Among five drivers (28%), a ≥ 36 mg/dL drop was observed within 20 min of starting their journey. Journey duration was positively associated with maximum glucose change. These findings support current guidelines to start driving with glucose >90 mg/dL, and to be aware that glucose levels may change significantly within 20 min. A CGM-based, in-vehicle display could provide glucose information and alerts that are compatible with safe driving. Clinical Trial Registration number: ACTRN12617000520336.

Original languageEnglish
Pages (from-to)350-356
Number of pages7
JournalDiabetes Technology and Therapeutics
Issue number5
Publication statusPublished - 10 May 2022


  • Blood glucose self-monitoring
  • Blood glucose/analysis
  • Driving
  • Humans
  • Road safety
  • Time in range
  • Type 1 diabetes

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