April 26, 2002
Hypoglycemia, Other Social Issues
Question from :
I have type�1 diabetes. Recently I was involved in a motor vehicle accident (totaling my car, damaging another, no one was seriously injured), and I was charged with reckless driving. The afternoon of the wreck, I was continually low, testing often, and taking around 15-20 grams of fast-acting carb per hour. Although I am on a pump, I occasionally get extended lows like this and boluses seem to stick around awhile so I can spend hours on suspension or temporary basal rates of 0.0. This usually happens when I’m very active, and it is not a common problem.
Before leaving work I was 66 mg/dl [3.7 mmol/L] so I ate 20 more grams of carb and hopped into the car, but a half hour later, I had the accident. At the time, I didn’t test so I can’t say I was low, but I couldn’t say for sure I was not. I felt fine, but had hypoglycemia unawareness that afternoon so that was not much help. I was, however, very much under 100 mg/dl [5.6 mmol/L]. I know this because adrenalin-induced worry and a continued temporary basal of 0.0 resulted in a blood sugar of 113 mg/dl [6.3 mmol/L] an hour later.
Would it be decidedly to my disadvantage to inform the judge of this? I have never been involved in a motor vehicle accident or received a ticket up to this point. Do first time offenders who had hypoglycemia get their license pulled (like I’ve heard)?
Answer:
My first inclination is to have you discuss this with your lawyer. There may be some long-term issues with your ability to drive and your liability. From a medical perspective, with hypoglycemia unawareness, you have entered into a very serious problem that threatens your well-being from now on. Without the ability to detect the low sugars, you are subject to recurrent episodes.
Previous studies have shown that avoidance of low sugars may allow you to recover some of your hypoglycemia symptoms and allow you to better predict lows. For now, see your doctor. I anticipate you will have to work on intensively avoiding low sugars. Finally, I would check your sugar every time you drive in the short-term. It is a safer alternative.
JTL
[Editor’s comment: One time I encourage patients to check their blood sugars (and eat if they are low!) is before driving. Also, check every hour if driving for a prolonged period of time. See Times you might check your Blood Sugar, at the Diabetes Monitor, for some additional thoughts.
WWQ]
