2010 BC Guide in Determining Fitness to Drive

GUIDELINES11.6 Private and commercial drivers with Type 2 diabetes that is not treated withinsulin or insulin secretagoguesApplicationAssessment guidelinesFitness guidelinesOSMV determinationguidelinesConditionsRestrictionsRe-assessmentguidelinesPolicy rationaleThese guidelines apply to driver fitness determinations for private andcommercial drivers with Type 2 diabetes treated with diet and exercise aloneor combined with: metformin (generic or under brand names Glucophage and Glumetza) acarbose (brand name Prandase) rosiglitazone (brand name Avandia), or pioglitazone (brand name Actos).OSMV will not generally request further information.Individuals may drive if they: report to OSMV if they begin insulin therapy, and remain under regular medical supervision to ensure that any progressionin their condition or development of chronic complications does not gounattended.Individuals are fit to drive.OSMV will impose the following conditions on an individual who is foundfit to drive: you must report to OSMV if you begin insulin therapy, and you must remain under regular medical supervision to ensure that anyprogression in your condition or development of chronic complicationsdoes not go unattended.No restrictions are required.OSMV will re-assess every five years, or in accordance with the schedule forroutine commercial or age-related re-assessment.OSMV will re-assess if insulin or insulin secretagogue therapy is initiated.Drivers with diabetes who are not treated with insulin or insulinsecretagogues are at little or no risk for hypoglycemia. Because diabetes is aprogressive condition, OSMV requires these drivers to remain under medicalsupervision and undergo a re-assessment every five years.Drivers who begin insulin therapy are required to report because of thesignificant increase in risk for hypoglycemia associated with insulin therapy.The requirement to report is intended to ensure that drivers on insulin therapymeet the more stringent driver fitness guidelines and conditions for driving.The requirement to report does not apply to insulin secretagogue therapy.Although there is some increased of hypoglycemia from the use of insulinsecretagogues, the risk remains small in relation to the risk from insulintherapy.90