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Driving While Diabetic: A Dangerous Combination

The recent incident in Oklahoma of a man in diabetic shock being "Tasered" by police, who mistook his medical emergency for intoxication, is fueling debate over the topic of increasing driving restrictions for diabetics.
It was a scene that anyone who has spent a few guilty moments enjoying the television program "Cops" might recognize: grainy video shot from a police cruiser of a truck that had spun out on an Oklahoma interstate; determined officers, trying to get a combative, disoriented driver out from behind the wheel. As the scene unfolds, the uncooperative and, evidently, intoxicated man is dragged from his truck by the officers and ultimately Tasered as they struggle to get him to cooperate. How many times have viewers watched similar scenes play out on television over the years, video after grainy video of other hapless drunks trying desperately to pass roadside sobriety checks?

At first viewing, this would have been just another drunk-driving arrest video. But this one was different: in this case, the "drunk" in question was not drunk at all. In fact, he was a 53-year-old diabetic in the full throes of diabetic shock.

My initial reaction, and I think that of many other viewers, was shock and horror that someone suffering a genuine medical emergency had been Tasered by officers rather than provided with immediate medical intervention. But as more details of the story emerged, particularly the similarity of the symptoms of diabetic shock as compared to the symptoms of alcohol intoxication, my consternation at the officers' treatment of the man abated somewhat. The more I listened, the more I began to get an inkling of why the officers might have made such a grievous mistake in the first place.

Some critics of police tactics in general might think that the diabetic shock-mistaken- for-alcohol intoxication angle was just another case of police trying to justify excessive treatment of a person in custody, but they would be truly mistaken. You see, diabetic shock can appear a great deal like drunkenness. According to the Website essortment.com, "As the diabetic's sugar level drops lower, the organ most affected by the change is the brain...As the brain's functions begin to decrease, the diabetic will become weak...The person may also become abnormally aggressive or uncooperative, could have slurred speech, and could easily be mistaken for being drunk or on drugs." At that point, my question changed from "Why did they Taser that poor diabetic?" to "What was that poor diabetic doing behind the wheel of a car in that condition in the first place?"

In all fairness to the man, diabetic shock can occur quickly; essortment.com states, "Like most medical conditions, low blood sugar is easiest to treat when it is discovered early, before it has become true insulin shock. There isn't very much time, because low blood sugar usually develops fairly quickly, over the period of less than an hour to just a few minutes." But learning that information only reinforces the question for me of why someone with a health condition that could, in the space of mere minutes, make him as dangerous as someone under the influence of alcohol, was driving at all. Yet surprisingly, at least in the United States, there are currently very few limitations or driving restrictions for diabetics. Far more limiting restrictions have been in place in Europe for almost a decade.

According to the American Diabetes Association, most of our states have a law that requests that people with diabetes present the Department of Motor Vehicles with a doctor's report verifying that they have diabetes, but it is, at best, a request. If diabetics comply, then that information is required to be on the diabetic's driving record and license. California's driving restrictions on diabetics are among the strictest in the country: after a diabetic is treated at a medical facility for a lapse of consciousness, even one not involving an automobile, medical personnel are required to notify the state, and a diabetic can have his or her license revoked, even for a first incident.

That may seem harsh to the ten million Americans diagnosed with diabetes, but for those whose sole concern is the safety of other drivers on the road, even California's restrictions may not be strict enough. In an article for savvyhealth.com, one woman shared her story of how her 60-year-old father had been struck and killed while motorbiking by a diabetic driver who had blacked out; the woman herself survived but sustained a fractured pelvis. To her, and to others of a like mind, the question is not how much of a restriction to place on diabetics, but rather, whether diabetics should be allowed behind the wheel at all.

The debate over what kind of driving restrictions should be placed on diabetics has certainly heated up in the wake of the Oklahoma Tasering incident, and it has many diabetics frustrated. Miriam Tucker, a medical journalist and diagnosed diabetic herself, expressed that frustration in an article on diabeteshealth.com, complaining that stories like that can "make it sound like people with diabetes irresponsibly get into a car and do not think about how they are feeling..." and that the message that is being put out is "Oh, my God, all these diabetics are out driving around."

Tucker and many other people living, and driving, with diabetes contend that it is possible to do so responsibly, and more importantly, safely. Kerri Morrone, a diabetic woman posting to the Web site dlife.com (devoted to learning how to live with diabetes), wrote in great detail of the measures, she personally takes to be safe behind the wheel. She always tests her blood sugar before driving; she always carries glucose tabs in the car; if her blood sugar is low, she has a snack before driving. However, she also admits that she has driven "out of necessity" while her sugar was low, and to having actually tested herself while driving, both behavior that only highlight the potential safety risks for diabetics and the drivers with whom they share the road.

Keeping track of low blood sugar before driving by testing oneself does help make things safer, but not all diabetics are so responsible, relying instead on how they feel rather than on test results for whether they should get behind the wheel. A study published in August 2008 in the Journal of the American Medical Association detailed just how unreliable, and dangerous, that practice can be. The study reported, "people with Type 1 diabetes may not judge correctly when their blood sugar levels are too low and may consider driving with a low B.G. [blood glucose]". In other words, in the early stages of a low-blood sugar incident, diabetics may already be suffering from judgment impairment and so may decide, erroneously, that they're "okay to drive". That is an uncomfortably similar scenario to that of a person who has had a couple of drinks at the bar but still "feels okay to drive", with true blood-alcohol levels well over the legal limit. Is a diabetic making a similar decision any less dangerous?

Diabetes is a terrible thing with which to live; it affects all aspects of the sufferers' lives, and the lives of those around them. Constant testing, restricted diets, and health complications are difficult enough for diabetics, and no one wants to punish them further by imposing harsh driving restrictions on them. But the sad fact is that for every responsible diabetic out there who conscientiously monitors his levels before driving and who absolutely refuses to get behind the wheel if his level is in doubt, there are other diabetics who are not so conscientious, and the frightening implication of that fact is that everyone is less safe on the road because of their behavior.

Until someone comes up with a way to ensure, every diabetic has checked to make sure that his or her glucose levels are within a safe range for driving prior to their getting behind the wheel, perhaps a blanket restriction is the best that can be done. After all, each state already has a blanket restriction on blood-alcohol levels to protect drivers from those driving under the influence; should diabetics be treated any differently when the symptoms of diabetic shock are so very like those of intoxication?

It was a terrible mistake that the man in Oklahoma was Tasered rather than given immediate medical assistance; however, if he had not been behind the wheel in the first place during a time of diabetic emergency, those officers would never have been placed in the position of mistaking his grave medical condition for a drunk-driving scenario worthy of a"Cops" episode. Instituting more stringent driving restrictions for all diabetics is not a matter of punishing diabetics, but rather a matter of increasing safety on our roads for everyone.
By Julia Tagliere
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