For years, diabetes has been a taboo term in the trucking industry. If an individual had insulin-treated diabetes mellitus (ITDM) fifty years ago, they were deemed “physically disqualified to drive”. This stipulation arose from fear of increased vehicle accidents related to hypoglycemic or hyperglycemic episodes (periods of time when blood glucose is too high or too low and can cause altered mentation).
This regulation has changed many times over the years; however, as of November 2018, individuals with ITDM are able to obtain a Medical Examiner’s Certificate from their clinicians that allows the individual to drive for 12 months at a time. This form includes the individual’s physician affirming compliance with insulin and management as well as denying any damage related to uncontrolled diabetes (retinopathy, neuropathy, etc.). Individuals with ITDM are also required to maintain an A1c of 7% to 10%. A1c is the average amount of sugar in the blood over the past three months. If the individual's A1c falls between 10% to 12%, a 3 month certificate will be given in which time the driver is required to lower his or her A1c below 10%. Failure to lower A1c in that time would result in not being cleared to drive and failure to meet any of these requirements could result in suspension.
With these strict regulations, it is understandable why diabetes can be such a taboo, nerve-wracking diagnosis for drivers. Controlling blood sugar through lifestyle factors such as diet and exercise as well as staying consistent with medication are of utmost importance. Lifestyle changes can make a huge impact on blood sugar control. Physical activity can lower blood sugar levels for up to 24 hours after exercise. Of the three macronutrients that the body uses for energy—carbohydrates, fats, and proteins—carbohydrates have the greatest impact on blood sugar levels. Keeping track of how many and what type of carbohydrates an individual with ITDM eats throughout the day (and night) is another important step in managing A1c levels and overall health.
Unfortunately, there is a 50% higher occurrence of diabetes in truck drivers than the national average. The likelihood of developing diabetes as a driver increases due to reduced physical activity, increased consumption of convenience foods (which are high in carbohydrates), and disrupted sleep schedules. Diabetes is a serious chronic condition and poor management can significantly impair an individual’s driving ability.
For tips on how to better control blood sugar through lifestyle changes check out our Facebook post here.
Written by: Claira, Cox Dietetic Intern