Going low while driving

I’ve read several discussions and comments here lately that have mentioned people going low while driving, and want to understand more about the experience of going very low, since it’s never happened to me (I’m T2 and only take Metformin).

Some of what I’ve read suggests that a person can go very low super fast under some circumstances, and that’s what I’m mostly wondering about – how fast it comes on. I can understand going HIGH pretty fast, from glucose being poured into the bloodstream … but how does it get OUT of the blood that fast? One person mentioned going from over 300 to under 30 in something like 15 minutes. I know too much insulin for too few carbs can be dangerous … but is that the only mechanism at work here?

Also, I’m under the impression that these severe lows can happen really suddenly, with no warning. What causes them to be so unpredictable?

I’m sure this must be a very sensitive topic and I really hope not to offend anyone … but I guess my biggest question is about whether people should be driving at all if there’s a regular possibility of going low quickly enough to crash the car. I’m NOT saying diabetics should give up driving! I just really want to understand how this works, and how people can be sure they’re going to be OK while they’re driving – or doing any other dangerous activity.

Thanks for any insights you can share.

I cannot begin to speak for everybody; I can tell when my body is having a low better than high. The symptoms I get for a low are the shakes, sweat (but not always) and the most noticeable is my tongue and lips get a tingling sensation when that happens and I test I’m in the range of 40 or below. My body seems to handle a low BS fairly well 70 to 50 the lowest I ever got was a 27 and it was before lunch and the best that I can explain it was I saw my wife’s mouth moving but nothing coming out and I had this dazed look. My wife knew right away and was able to get me to drink OJ but that was the only time.
I always have Glucose tabs in my vehicles, work locker, golf bag or in my pocket it’s rare that I need them but have on occasion used them, so far never while driving. For some reason when I go on a driving trip or travel (Air) my BS is on the high side.

I believe the majority of my lows are a result not eating on schedule ( skipping ) having a couple of beers and not eating or if I miss calculate with the Bolus and take to much insulin for what I’m eating.

I take Levemir for a Basal and Novolog for the bolus

Like John, I can usually tell when I’m going low. I get light headed, dizzy and start shaking so aside from a few occasions where I’ve gone low and had no idea, I know when it’s happening. When I’m driving, I get extra-obsessive about making sure my sugars are what they’re supposed to be. If I know I’m going to be driving for longer than half an hour and I’m hovering in around 6 (that’s 108 in US readings), I would still eat something just to make sure I don’t drop unexpectedly. I also keep an emergency coolbag in the car which has everything I’d need if I did happen to go low while driving.

As for the possibility that diabetics shouldn’t drive…when I’ve heard that before, I’ve always automatically thought, well if a non-diabetic had a bad cold and kept sneezing, would you tell them not to drive? Even though when you sneeze your eyes involuntarily close and all it takes is a split second for an accident to occur? I think if people with diabetes were told that they couldn’t drive, it would also be reasonable to assume that people with asthma shouldn’t drive in case of an attack, or someone who is pregnant shouldn’t drive in case they go into labour…or even that someone who has a cold shouldn’t drive in case they sneeze, lol. The point I’m trying to make is that no one, even people with no previous history of any major illness, can really assume that they’re going to be ok while they’re driving. People with diabetes just have to take a few extra precautions, that’s all. :slight_smile:

If I am going to be driving for an extended period of time, longer than an hour or so, I test before I take off. I always have stuff with me, jerky (protein and a few carbs), cheese and crackers (one of my favorite snacks now), 100 calorie packs of various snacks, glucose pills, etc. Like John, I can normally tell I am getting lower than I want to be by the tingling sensation around my mouth. When I am driving I always feel like I would rather be running just a little bit high than to go low. On extended driving trips I probably check more often than normal, jst to be safe.

The deep lows we read about that can cause serious damage are usually related to insulin use and hypoglycemia unawareness. When serious lows happen to T2s, it is because we are either overmedicated in general or – more usually – on a medication that is designed to counter postprandial highs (such as Starlix), and we’ve eaten less than the medication will “cover”, or we’ve been fasting or undergoing heavy exertion without eating while taking a medication that inhibits glycogen-to-glucose conversion (such as metformin). They are usually not nearly as deep as the lows of insulin-dependent diabetics (my doctor told me I’d pass out if I let my blood glucose get down to 50).

i always carry with me a small pouch having a few chocolate bars and some sugar–this ouch or small bag is at an arms length—so if i feel some tingling or a bit dizzy i stop my car or stop my regular walk and take something and carry on–i have xpereienced it ona few occassions during last few yrs

My sugars can drop really quickly. Especially if I exerted some physical effort. Or didn’t eat enough. Most of the time though they don’t drop when I am driving. (luckily). The worst part is that if you can’t feel them get low until they are already low you are kinda in trouble pretty quickly. I usually have no idea my sugars are low until they are below 60. That means that if I am driving and I feel them going low, I am already in the 50’s before I can do something about it and if there is not anything in the car, it might get into the 40s or 30s before I can.

The moral of the story is to test before driving. I can’t say I do it all the time, but I certainly test within 30 minutes or an hour of driving.

I know when I’m low & have the same symptoms the others mentioned–I feel out of it, fuzzy, my hands shake. I have glucose tabs in the car console where I can easily get to them. So far, knocking on wood, I’ve never experienced a low while driving. I check BG before getting into the car & have a snack before a long drive. On really long trips, I stop & test. Since being diagnosed, I’ve become a more careful driver because I don’t want anyone blaming a mishap on a diabetic being behind the wheel! I don’t speed like I used to.

Though some lows I can’t explain, mostly it’s been from too much insulin & not enough food when I’m really active. Personally, I’ve not experienced going super low super fast. I can feel it coming on.

I think I was hypoglycemic frequently before being diagnosed, so my body handles lows pretty well. It’s when I get below 60, that I feel strange. I can feel the highs, too, because my head starts to pound.

The Staples by me is clearing out its stock of “binder accessory” pouches for $1.80 each. These pouches are large enough to fit a small meter (such as a Flash/Freestyle Lite or a Keynote) with elastic loops which are slid onto (included) elastics with plastic clips that are designed to fit over the top and bottom of the front cover of a standard looseleaf binder. With a half-twist of the elastic, this can be secured around the short dimension of your flip-down visor. Your existing meter case for your portable meter may be able to be slid/velcro’d onto this elastic such that you can always keep a meter at hand in the car (please do not store the strips in the car!).

I just acquired one of these cases this evening; I’ll have to take some photos and post them as examples.

What a great idea! Thanks for suggesting that.

Since my diagnosis I almost never drive anymore, but not because I’m afraid of going low – it’s because I have to exercise for about an hour every day to keep my BG in check, and I’m too lazy to go to the gym – so I get the exercise by riding to work and back. I have an extra meter (a OneTouch UltraMini) that I never use, but it takes the same strips as my regular meter. Thanks to your suggestion I’m going to start keeping the mini meter in my bike bag, and an extra vial of strips in my messenger bag so I can have the option of testing before I ride. Like I said, I don’t ever go super low, but the other night I felt kind of dizzy after I got home and tested at 59. Probably should’ve eaten a little something before I started out.

Going low fast is scary and it has happened to me while driving. This summer I went on a road trip with my mother and a friend. I had put regular peppermints in the car for my traveling buddies. Wow did they come in handy when I went low. I have glucose tabs, but I would have to dig through my purse to get them. The peppermints worked great and pulled me right out of it. Right now I am wearing a continuous glucose monitoring system. It reads blood sugars every 5 minuets and has an alarm if I go below 80. That gives me the time to respond before the shakes begin. The doctor thinks my lows have to do with my Lantus insulin which is the slow acting one that I take at night. It releases insulin throughout the day and has certain peaks which can make me go low unexpectedly. I have decided to always have peppermints in the car. Great for those who can enjoy, and great for me it I need one.

Getting low driving a car is probably one of the most dangerous situations a T1 can be in, especially when there are passengers in the car. IMO you should get off the road (if u feel low or are dexterous enough or have passenger help to test en route) and test/treat the low (with glucose tabs) before driving again. Should also test your BS before getting behind the wheel (I don’t drive unless my BS is at least 90) and test periodically en route if driving longer distances - preferably while not driving ;-). I have a continuous monitor now which when callibrated properly has proven invaluable in these situations.

You pretty safe with metformin.It’s ussally happen by taking insulin injections. The biggest thing is to be prepared and act fast. I keep a bag of skittles next to me in the car. If I fill shakey while driving I chew a few of them (taste the rainbow).I have glucose tabs but while driving it’s a pain to fumble with. I don’t wait to take a BG reading while on the road .But I stop soon as I can and check it and eat some protein.

I have hypo unawareness and I can be really low without knowing it. Then another small drop will be disaster. When I say really low I mean 20 or sometimes less, even though I feel fine with no symptoms of being low.
I have been in an accident (14 years ago) brought on by these drastic, quick lows. I was driving along a highway and may have been doing 70mph when suddenly everything became blurry. Then I heard the sound of the tires on gravel and I hit a solid rock wall. The car was totalled and I ended up with some bruising from the seatbelt and a gash over 1 eye.

I don’t know if we’ll ever know why they happen, especially when you have done everything right up to that point before getting in the car. Most times it is because we messed up somewhere along the line, accidently took too much insulin, didn’t eat enough, extreme stress, or many other reasons.

You wonder about diabetics driving if there is a possibility of an unexpected low and the harm it can cause. What about heart attacks, epilectic seizures, being allergic to bee stings and being stung by a bee, what about … and the list goes on. And those are the people with medical conditions. How about drunks or druggies. How about the bad or reckless drivers.

One cannot discriminate against diabetics without taking into account the rest of the drivers and their conditions. If you did, there would not be very many cars on the road.

I’ve put up a photoessay on using these (or similar) items in your car on my latest blog entry.

I used to go low while driving all the time . Why do I say used to? Because I got a new pancreas on June 17, 2008 and my blood sugars are perfect now. I can drive again and will return to work. For the first time in over six years my life is normal . I only had type 1 diabetes for a little over six years. But I had severe hypoglycemic reactions leading to death once and a stay in the ICU on a ventilator with a swollen brain another time for a week. I was supposed to be permanently brain damaged after that, according to the neurologist. Anyone considering a transplant-it’s the smartest thing I’ve ever done. Sure taking the antirejection drugs sucks. But everything else is great. As far as driving goes I wouldn’t do it until I was sure that I would not go unconscious due to low episodes. Anyone curious about the transplant I can be e-mailed at colleenmariemyers@verizon.net and I’ll answer any questions. Colleen