Driving with Diabetes
There are a number of things to consider when driving a motor vehicle if you have diabetes. It is a driver’s responsibility to avoid low blood glucose levels whilst they are driving – your blood glucose level must be above 5 mmol/L before you drive and you must have the necessary equipment to monitor your blood glucose levels and treat hypoglycaemia.
It is your legal responsibility to inform the Driver Licensing Authorities in your State or Territory if you take blood glucose lowering medications, including insulin. In Victoria, drivers are required under law to notify VicRoads if they have, or develop, diabetes and to provide an initial medical report.
You should also notify your motor vehicle insurer.
The NDSS Diabetes and Driving booklet provides further information for drivers.
Travelling with Diabetes
It is important to plan ahead to ensure you make the most of your travel. Please discuss your travel plans well in advance with your GP, Endocrinologist or Diabetes Educator. A list of requirements and recommendations is available on the NDSS (National Diabetes Services Scheme) website contained in their Travel Fact Sheet.
Treating Diabetes with SGLT2 inhibitor medicines
There are some important things to know if you are prescribed an SGLT2 inhibitor to treat your diabetes. Examples of these medications include Dapagliflozin (Forxiga®), Dapagliflozin + Metformin (Xigduo®), Dapagliflozin + Saxagliptin (Qtern®), Empagliflozin (Jardiance®), Empagliflozin + Metformin (Jardiamet®), Empagliflozin + Linagliptin (Glyxambi®).
The attached leaflet has information about what to do if you become unwell or need surgery (including endoscopy) when taking these medications.
Sick Day Management for Type 1 and Type 2 Diabetes
Should you become unwell it is important to know how this may impact your diabetes treatment. Your Endocrinologist and Diabetes Nurse Educator will work with you to create an individualised plan.
A Sick Day Management Plan For Type 1 Diabetes will include advice about testing for ketones and how to manage your insulin regimen.
A Sick Day Management Plan for Type 2 Diabetes will include advice about which medications may need to be adjusted or temporarily withheld.
Surgery (including endoscopy) and Diabetes
Type 1 Diabetes
If you require a surgical procedure (including gastroscopy and colonoscopy) that involves fasting is important that you have a management plan for your insulin therapy (multiple dose injection or pump) and blood glucose monitoring (finger stick or continuous glucose monitor). Your Endocrinologist, Diabetes Nurse Educator, GP and / or Anaesthetist will be able to advise you. It is important that you have a clearly documented management plan.
Type 2 Diabetes and SGLT-2 Medications
SGLT-2 agents must be withheld prior to planned surgical or endoscopy (gastroscopy, colonoscopy). Your Endocrinologist, Diabetes Nurse Educator, GP and / or Anaesthetist will be able to advise you about how to manage your diabetes whilst this medication is withheld.
Type 2 Diabetes and GLP-1 Medication
In some instances it may be advisable to omit your dose of your GLP-1 agent (Ozempic®, Mounjaro®) prior to a planned surgical procedure or endoscopy (gastroscopy, colonoscopy). Please discuss this with your Endocrinologist or Anaesthetist.
Sick Day Management with Corticosteroid Therapy
Corticosteroid (hydrocortisone, cortisone acetate, prednisolone, dexamethasone) doses usually need to be increased in the event of illness or surgery (including endoscopy). Your specialist will work with you to create an individual management plan. A link to the Hormones Australia template is provided below. It is also important to ensure that you have up to date Emergency Medical Alert Identification.
Medication for Hyperthyroidism
Carbimazole and Propylthiouracil are oral medications used to treat an overactive thyroid. Side effects are uncommon but may rarely be serious. A link to the Hormones Australia information sheet containing advice about what to look out for is provided below.