Diabetes And Driver’s License Restrictions
Have you ever wondered what the exact rules are, when it comes to diabetes and drivers license restrictions? We sure do, every time news stories pop up about unsafe driving involving PWDs .
We looked into this, and essentially learned that state laws differ a comprehensive review by the American Diabetes Association a few years ago shows that roughly half the states at the time had no required restrictions, while the other half had restrictions that were enacted into law.
Exception To The Rule
Applying for exemption if you take insulin
If you have diabetes, and take insulin to treat it, under federal law, you must apply for an exemption from the Federal Motor Carrier Safety Administration to drive an interstate bus.You can visit the FMCSA website, , and download the application for the diabetes exemption.
As part of the diabetes exemption process, you will be evaluated by an endocrinologist, an eye doctor, and a certified medical examiner. Each of these doctors will complete a form where they will describe your diabetes, how well it is managed, and why you should be allowed to drive commercially and obtain a CDL.
Unfortunately, this is a long process. Estimated time response for a yes, or a no can take up to 180 days, or six long months. The exemption lasts for two years. You can learn more about the driver exemption program to obtain a CDL when you use insulin for your diabetes by visiting: .
How To Obtain Medical Certification
Insulin-using drivers must complete three steps before they can be medically certified:
Step 1: Monitor blood glucose levels. A driver with ITDM is required to follow his or her treatment plan and maintain blood glucose records using an electronic glucometer. The glucometer must be able to record the date and time of each reading. Typed or handwritten logs are not acceptable.
Step 2: Visit the treating clinician . The driver must make an appointment with his or her TC, the healthcare professional who manages and prescribes insulin for the treatment of his or her diabetes. The driver must provide the TC with at least the previous three months worth of blood glucose records. This is achieved through either presenting the glucometer or a printout of the devices electronic records.
If the TC determines that the drivers diabetes is controlled, he or she then completes an FMCSA document, the ITDM Assessment Form to attest to this fact. The driver may need to bring a copy of the form to the appointment if the clinic does not provide it.
Step 3: Schedule an FMCSA exam. The driver must schedule a medical exam within 45 days of the ITDM Assessment Forms completion with a medical examiner listed on the National Registry of Certified Medical Examiners.
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Have Your Treating Physician Fill Out The Insulin
This form applies to drivers with diabetes who are insulin-dependent or moving on to getting treated with insulin. Your healthcare professional, or the doctor who prescribes your insulin medications, must fill out the assessment form from the Federal Motor Carrier Safety Administration.
This should outline and describe how stable your insulin treatment program is. It should also clearly define how youre taking control of your diabetes.
Examiners for the DOT Physical of drivers with diabetes will look into your A1C level. Ideally, it should consistently be at 7 to 10 percent for a period of two to three months, which will be indicated in your attending physicians assessment.
Thus, youll need to visit your diabetes doctor at least a few months before you get your DOT physical in Hernando County, so that you have enough time to work on your blood sugar level logs. Drivers with no glucose logs ascertained by their doctor might still get a medical certification on the condition that they have to work with their doctor for the next few months.
Plan Meals And Snacks
If youve had diabetes for a while, you already know how important it is to plan your meals and snacks. But this is especially important when driving long distances as a trucker. Keep healthy snacks and small meals on hand when possible. Nuts, fruits and veggies, granola bars, and sandwiches are all easy and healthy snack options to keep on hand. Plan stops for locations with healthy meal options instead of spots that only offer fried food.
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Does Diabetes Impact Dental Health
The higher your blood glucose level, the greater your chance of developing: Cavity decay . Your mouth includes several sorts of microorganisms. Plaque builds on your teeth when the carbohydrates and sugars in meals and drinks interact with these bacteria.
I was just diagnosed with high blood sugar for the first time in my life. Im 48 years old. Diabetes runs in my family. I had no idea Id acquire it, but my doctor stated it was at an all-time high of 275+ and that I needed medication. I turned down the doctors offer and asked for a month to get it under control and rechecked. I got the pills here and began using them in conjunction with my diet. My doctor gave me the tester so I could monitor my blood level at home. After a week of taking it once in the morning before breakfast and once in the afternoon before lunch. Id check it in the evening. Surprisingly, it was at 102,105, and once at 98. And depending on what and how much I eat, it would rise to 120-128 after supper. A month later, I returned for my checkup, and everything was OK. Doctors say that if I stick to my healthy diet and exercise routine, Ill be OK. It actually works!! Ill be getting another bottle shortly.
History Of Law From 2005
As part of a transportation bill from 2005, a person with Type 1 Diabetes who takes insulin is now able to drive in interstate commerce. This had not been possible before this law, and persons taking insulin were unable to be truckers. Although there are many requirements that the person must meet, it is possible.
Truckers are one of the unhealthiest segments of the population, due to unhealthy eating habits, irregular eating schedules, long hours and lack of exercise. Therefore, being a trucker with diabetes comes with its challenges. However, some feel that these challenges are worth the independence and opportunities that trucking the open roads of the United States provides.
The FMCSA started to provide assessments of those with Type 1 and Type 2 diabetes taking insulin for interstate trucking on a case-by-case basis as early as 2003, provided that they met all conditions for driving while taking insulin. The criterion is not as strict as one might think, keeping in mind that those with existing complications of diabetes, or those with an A1C that is high, generally above a 10, may not be able to go through the process.
The process is very long and can take up to 180 days or longer if they find that the applicant has left out information needed to make a confirmed assessment. Some sources have sited 9 months to 1 year of wait periods, due to back log of paperwork with the cumbersome process.
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Avoid Smoking And Drinking
Its high time to avoid vices that may only complicate your diabetes. According to the Harvard School of Health, nicotine can increase your diabetes risk by as much as 50 percent so its worth making a conscious and active effort to curb your smoking and drinking habits as early as possible.
If youre having a hard time quitting smoking or drinking, you might want to enter into health programs that encourage you to slowly stop craving nicotine or alcohol. If you cant make drastic changes in your alcohol intake, at least try to drink a maximum of two glasses a day and a glass a day .
Road Rules For Diabetes State By State
As with most things in life and in diabetes, your specifics may vary depending on where you call home.
For example in my state of Michigan, the laws pretty limited. The forms require only that a person indicate whether theyve had any any medical issues or specific instances of unconsciousness in the past six months. If so, you are required to get a doctors evaluation saying youre OK to drive.
Previously, while I was living in Indiana, the state law was even more broadly worded to ask if the driving applicant is subject to fainting spells or seizures of any kind, or has a condition that makes him or her appear intoxicated. Because Id had a past experience there of going low behind the wheel, I always had an endos note on file saying I was OK to drive but fortunately, this stated restriction never actually came up when I was renewing my license.
Other states actually require medical evaluations and/or agency reviews if an applicant has a history of health issues or demonstrates the potential for such. California puts the requirement at the past five years of any issue while driving, while New York is one of the most strict, requiring applicants to report whether they have EVER received treatment or taken meds for a condition which causes unconsciousness or unawareness. Well, yeah hello, insulin! In that state, you must adhere to a medical evaluation and review before getting a license.
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Intrastate Guidelines For Cdl With Diabetes
If you want to work in the trucking industry only within your state, and you do not plan to cross any state lines, you can get approved to drive a commercial vehicle in your state. For drivers driving within state lines, you do not need to apply for the Federal Diabetes Exemption.
Likewise, you would not need to apply for the Federal Diabetes Exemption if you do not use insulin. Whatever rules and regulations your state has for holding a CDL with diabetes is what you have to follow for intrastate or interstate trucking.
It is important to know that most commercial driving will be considered interstate, not intrastate driving, even if you do not cross state lines. If you are carrying cargo or passengers to or from another state, this is also considered as interstate commercial driving. For information on intrastate commercial driving, check with your home state for CDL requirements and see if they are applicable to you.
They vary from state to state, with each state having its own regulations. You can look up the laws governing your state by visiting this page at the American Diabetes Association website, . You can type your home state in the search for laws and requirements for intrastate trucking where you live.
- Type 2 and no insulin: Can I get a CDL?
- Type 1 Diabetes Can I get a CDL?
S For Qualifying Drivers Who Use Insulin
A driver with a commercial drivers license who becomes medically unqualified, even temporarily, may have his or her CDL downgraded.
It has been argued by many over the years that commercial drivers with controlled insulin-treated diabetes mellitus should be medically certified, provided they are otherwise physically qualified. And, it appears as if the Federal Motor Carrier Safety Administration was listening.
As of Nov. 19, individuals with a stable insulin regimen and properly controlled ITDM may be medically certified for up to one year to operate commercial motor vehicles in interstate commerce. Certification of drivers with ITDM no longer requires the considerably more time-consuming medical exemption from the FMCSA.
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What The Assessment Involves
Under the new ruling, a listed certified medical examiner can grant a person with insulin-treated diabetes a MEC for up to 12 months.
To do so, the healthcare professional who manages and prescribes insulin for the person provides the assessment form to the CME. The CME will then determine if the person meets the FMCSAs qualification standards.
- following a stable insulin regimen
- managing the diabetes
- not having severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy
- being able to self-monitor and record blood glucose readings
The FMCSA estimates that the annual cost to comply with this ruling is $332, which is significantly lower than the cost prior to the 2018 rule change.
Complications Between Med Cards
Drivers with ITDM who are certified, but later suffer a severe hypoglycemic episode, are considered medically unqualified. A severe hypoglycemic episode requires the assistance of others or results in loss of consciousness, seizure, or coma. The driver must report the episode to the TC as soon as possible.
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Type 1 controlled with insulin injections, no. Type 2 controlled with medication, yes.
Can I get a cdl and a job being a diabetic?Click to expand…
Yes you can! However, if the said diabetic is taking insulin for control they must comply with 391.46.
Federal Register :: Qualifications of Drivers Diabetes Standardand the 391.46THIS ONE WILL answer your question. If you do not have the free Adobe PDF Reader, find one and pull it so you can do this. Without going off the deep end on this subject there is a special type of Coma that threatens some diabetes people. My father has type two. Who is not to know I will develop it someday. If you get this type of coma coming on at interstate speeds and 40 ton 18 wheeler, you are going to kill and hurt so many people. BE VERY careful and think this through pertaining exactly to your exact diabetes situation.
Type 1 controlled with insulin injections, no. Type 2 controlled with medication, yes.Click to expand…
A Truckers Fear Of Insulin
Recently, a trucker named Jason, came to me for diabetes education. Jason is a 54 year old Type 2 on 3 different oral medications that are all maxed out. He wanted to talk with educators about lifestyle changes that he could make to avoid getting put on insulin injections. He confessed that it was tough to drive a rig when you have to take insulin. He said the process was hard, and he knew others who could not make it through. However, he did not want to lose his income.
Because he was at the maximum with his oral medications, his doctor was pushing for the next step. Jason was clearly trying to avoid insulin because he was a truck driver. After going on an intensive diet and exercise regimen, he was able to get his A1C down to a 9.8. Still, he is looking at his diabetes worsening due to having had Type 2 for 12 years. As his beta cells die out over time, and there is a worsening of his condition, he will likely not be able to stay on the interstate roads for much longer.
Are many truck drivers afraid to take insulin for the fear of being unable to drive in interstate commerce? It seems that this may be the case, as evidenced by Jasons story. This may be the only life and career a person knows, and switching careers late in life, as we all know, can be very difficult. Hopefully with good self-management skills being taught, diabetes educators can help in keeping Americas dedicated trucking industry rolling, and help Jason and others like him keep on truckin on.
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How To Apply For The Diabetic Exemption Program
Diabetic drivers who apply for the exemption should download a copy of the application, which is available on the FMCSA website. It could also help if you were evaluated by an ophthalmologist or optometrist and an endocrinologist. These doctors must provide specific information regarding your diabetes. The agency may request additional information as well.
Implementing Changes In The Dot Program For Diabetic Truck Drivers
The 2005 DOT regulations for the Diabetic Exemption Program follows the recommendations of the FMCSA Expert Medical Panel. The panel recommends that insulin-dependent drivers be on medical observation during the first 1 2 months of driving. The medical board also suggests that the drivers A1C levels remain between 7 and 10 percent.
The DOTs new regulations require drivers who are Type 1 Diabetic to take insulin for a minimum of two months before being eligible for the exemption. Those who have Type 2 Diabetes are only required to use insulin for one month before being eligible for the exemption.
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Benefits Of The 2018 Diabetes Regulation
The FMCSA has highlighted several strong reasons for the 2018 regulation repealing the exemption program.
- It was determined that the new allowance would achieve a level of safety equivalent to or greater than the level that would be achieved by complying with the current regulation.
- The change delivers economic savings to affected drivers and to the FMCSA, and streamlines processes by eliminating unnecessary regulatory burdens and redundancy.
- The final rule will eliminate the exemption program that currently requires individuals with ITDM to incur recurring costs to renew and maintain their exemptions. FMCSA estimates this will save the nearly 5,000 individuals with ITDM that currently have exemptions more than $5 million per year more than what they would endure under the exemption program. The final rule will also save new ITDM exemption applicants and their associated motor carriers approximately $215,000 annually in opportunity and compliance costs related with the exemption programs waiting period.
- As an agency, FMCSA will save more than $1 million per year over the next three years in costs associated with administering the diabetes exemption program.