My 26 year old husband, who has had type 1 diabetes for 24 years and is wonderful at taking care of himself, was recently in a car accident that was a result of a low blood sugar (paramedics measured 30 mg/dl [1.7 mmol/L]). We believe the sudden drop was a result of unusual strenuous activity. My reason for asking is more that his parents believe he is the only person with diabetes who has had this occur. Have you heard of other people with diabetes having car accidents due to low blood sugar levels?

Unfortunately, this is not an uncommon story. I advise all my patients that they must be extremely careful not to have a low blood sugar while driving. Even if they think they can drive safely with a mild low blood sugar, they can’t. (It’s like people who think they can drive safely when they are a “little drunk” but can’t.) They should always have some emergency food within reach to eat or drink while driving in case they can’t stop to test and eat. While driving, it’s better to eat a little extra by mistake, then go low by mistake. If they aren’t aware of the early warning symptoms of a dropping blood sugar they have to be even more careful, both for their own sake, and for the sake of other drivers and pedestrians on the road.

I hope your husband didn’t suffer any serious injury and no one else was hurt.

TGL
Additional comments from Dr. Larry Deeb:

Unfortunately, this is all too common. I personally have lost patients to fatal crashes because of hypoglycemia. Likewise, most state driving license agencies will revoke the driving privileges after such an event, so I know they know about this.

LD
Additional comments from David Mendosa, A Writer on the Web:

A few years ago, several people wrote me on behalf of a young man, who was then 22 and had type�1 diabetes since he was four. He had an automobile accident, on his way back to class studying to be a correctional officer and was due to graduate in four weeks. He was taking a break from class to go job hunting at a prison. The accident happened during the day, and he hadn’t had anything to drink, as tested afterwards with a breath analyzer. My correspondents say that he had an hypoglycemic episode that caused him to lose control of the car and kill someone. He was found guilty of vehicular manslaughter and sentenced to ten years in prison.

DM
Additional comments from Lois Schmidt Finney, diabetes dietitian:

Certainly we all have stories of those with diabetes who get too low while driving. We had a patient who drove the wrong way on a freeway and crashed into a wall. Miraculously, he survived. Unfortunately it can happen that a fatal accident is caused by someone driving crazily due to a low blood glucose.

Now it is standard that we recommend that folks with diabetes who are on oral medications or insulin test their blood glucose before driving, have a readily available source of glucose with them in the car (as glucose tabs), and whenever they feel the least bit funny, they stop, even if they are not sure what is going on. Maybe if you showed his parents these recommendations and that he is willing to follow them, they will be put at ease. I applaud you for your support of him (this is key for someone with diabetes to know they have support). I also applaud him for his efforts at taking the best care of himself as possible to be in the most optimal health.

LSF
Additional comments from Dr. John Schulga:

There was recently a court case in Scotland where the very same thing happened. I am unsure of the details, but the driver was a type 1 diabetic who had an accident because of a hypo.

JS

[Editor’s comment: I think there is a message here that should be a red flag for everyone who has diabetes and drives. Before getting behind the wheel, it is extremely important to check a blood sugar level and probably to eat at least a small snack as well, regardless of what the reading is. This is especially necessary after exercise. Remember that tight control and/or many years of diabetes brings with it hypoglycemia unawareness so that it is not always possible to detect early warning signs of an already low or rapidly falling blood sugar.

As a result of the magnitude of this problem in Canada, I believe that the law there now requires people with diabetes to measure a blood glucose level before driving and to have a log available for review. While this might seem extreme, I believe that it is fully justified because as Dr Lebinger has pointed out, “It’s like people who think they can drive safely when they are a ‘little drunk’ but can’t.”

Many accidents, injuries, and lives can be saved if people with diabetes will heed these precautions. In addition, every story like this tends to get the attention of the media which only leads to further discrimination against people with diabetes.

I hope the neither your husband nor anyone else was seriously injured in this accident and that perhaps he has learned something new so that he can continue to take wonderful care of himself and have an active, productive, long life.

SS]