Diabetes and Road Traffic

UPDATES TO CONTENT COMPARED TO THE PREVIOUS YEAR’S VERSION

Change 1: Patients should be made aware of possible inaccuracies in continuous glucose measurements and the time lag from blood glucose to tissue glucose, e.g. to avoid overcorrections at high values or false security at low values.
Reason: Information about inaccuracies may lead to greater caution against hypoglycaemia in the patient's self-management

Supporting reference: [4–7]
Change 2: "blood glucose measurement" has been changed to "glucose measurement".
Reason: Glucose measurement in tissue is becoming more and more common and should therefore be included. Further linguistic alignment is "controlled" rather than "measured". "Controlled" includes measuring, finger-sticking, reading, or scanning.
Change 3: Comma and "especially in severe depressive disorders" deleted in the sentence: "There are restrictions on driving safety in depression, especially in severe depressive disorders with psychotic syndrome.
Reason: Linguistic and substantive clarification. In the Driving Licence Ordinance, depression is only mentioned under "affective psychoses" (this is not a diagnostic chapter in ICD10), here as " very severe depression".However, "very severe" is not a diagnostic category in ICD10, it is " major depressive episodes with psychotic syndrome". With the omission of the comma, the meaning becomes clearer.Supporting reference: Driving Licence Ordinance, Appendix 4, Point 7.5, ICD10 GM F32.3
Change 4: Is the glucose value in the unproblematic range Reason: linguistic expansion from blood glucose to blood glucose*tissue glucose
Change 5: Instead of Is there a BG measuring device in the vehicle? Mandatory for blood glucose self-monitoring, also useful for continuous glucose monitoring: Is there a blood glucose measuring device in the vehicle?
Reason: Precision in terms of content: Certainty of having a second control option with CGM as well
Change 6: Complete revision of Practice tool 2 Recommendations for participating in traffic
Reason: Text needed revision in terms of language, layout and content. ALL road users are addressed, as, for example, pedestrians are also at risk of hypoglycaemia. Continuous glucose monitoring is included as it is now a common glucose control method for type 1 and type 2. The Road Traffic Ordinance and the Driving Licence Ordinance are mentioned as legal bases, while the StVO explains the prohibition of the use of insulin pumps and CGM devices while driving. The previous Practice tools 2 and 3 are merged into a new Practice tool 2 for better handling of patient instruction in medical practice.

These practical recommendations highlight important contents of the S2e guideline Diabetes and Road Traffic/Diabetes und Straßenverkehr. The guideline is available online at https://www.ddg. info/fileadmin/user_upload/01_Die_DDG/03_Ausschuesse/06_Sozia les/2017-Leitlinie_S2e_Diabetes_und_Strassenverkehr_Endfassung. pdf. The long version of the guideline is binding and includes all appendices and literature references as well as the methodology report of the standardised literature search.

The guideline was published by the German Diabetes Society/Deutsche Diabetes Gesellschaft (DDG) with the participation of: Social Affairs Committee of the German Diabetes Society/Ausschuss Soziales der Deutschen Diabetes Gesellschaft, Diabetes and the Eye Working Group/AG Diabetes und Auge, German Society for General and Family Medicine/Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM), German Society for Occupational and Environmental Medicine/Deutsche Gesellschaft für Arbeitsmedizin und Umweltmedizin (DGAUM), German Ophthalmological Society/Deutsche Ophthalmologische Gesellschaft (DOG), German Society for Psychology/Deutsche Gesellschaft für Psychologie (DGP), German Society for Transport Medicine/Deutsche Gesellschaft für Verkehrsmedizin (DGVM), German Society for Traffic Psychology/Deutsche Gesellschaft für Verkehrspsychologie (DGVP), Association of Diabetes Consultancy and Professional Training in Germany/Verband der Diabetes-Beratungs- und Schulungsberufe in Deutschland e.V. (VDBD), German Diabetes Association/Deutscher Diabetiker Bund (DDB), German Diabetes Federation/Deutsche Diabetes Föderation (DDF) and German Diabetes Aid – People with Diabetes/Deutsche Diabetes Hilfe – Menschen mit Diabetes (DDH-M).

Publication History

Article published online:
23 February 2024

• References

• 1 Bundesministerium der Justiz und für Verbraucherschutz. Verordnung über die Zulassung von Personen zum Straßenverkehr (Fahrerlaubnis-Verordnung – FeV). 2014
• 2 Bundesanstalt für Straßenwesen (BASt). Begutachtungsleitlinien zur Kraftfahreignung. Bergisch Gladbach, dated 31.12.2019
• 3 ArbSchG Arbeitsschutzgesetz. Gesetz über die Durchführung von Maßnahmen des Arbeitsschutzes zur Verbesserung der Sicherheit und des Gesundheitsschutzes der Beschäftigten bei der Arbeit (Arbeitsschutzgesetz ArbSchG) vom 07.08.1996 (BGBl. I 1246), geändert durch Artikel 8 des Gesetzes vom 19.10.2013 (BGBl. I S. 3836). 2013
• 4 Alva S, Bailey T, Brazg R. et al. Accuracy of a 14-Day Factory-Calibrated Continuous Glucose Monitoring System With Advanced Algorithm in Pediatric and Adult Population With Diabetes. J Diabetes Sci Technol 2022; 16: 70-77
• 5 Avari P, Uduku CH, George D. et al. Differences for Percentage Times in Glycemic Range Between Continuous Glucose Monitoring and Capillary Blood Glucose Monitoring in Adults with Type 1 Diabetes: Analysis of the REPLACE-BG Dataset. Diabetes Technol Ther 2020; 22: 222-227
• 6 Freckmann G, Link M, Pleus S. et al. Measurement Performance of Two Continuous Tissue Glucose Monitoring Systems Intended for Replacement of Blood Glucose Monitoring. Diabetes Technol Ther 2018; 20: 541-549
• 7 Pleus S, Kamecke U, Waldenmaier D. et al. Time in Specific Glucose Ranges, Glucose Management Indicator, and Glycemic Variability: Impact of Continuous Glucose Monitoring (CGM) System Model and Sensor on CGM Metrics. J Diabetes Sci Technol 2021; 15: 1104-1110
• 8 Verordnung über die Zulassung von Personen zum Straßenverkehr (Fahrerlaubnis-Verordnung – FeV) Anlage 4 (zu den §§ 11, 13 und 14) Eignung und bedingte Eignung zum Führen von Kraftfahrzeugen.