Commercial drivers include people who have licenses to drive commercial trucks, buses, taxi, etc. As these people are driving for longer hours and sometimes on a shift-work basis they may be at a greater risk of developing hypoglycemia than drivers of private vehicles. There is also concern about the size of some vehicles (buses and trucks) and the extra danger that size entails.
CDA Guidelines for Commercial Drivers
 | All the guidelines listed for private drivers must be upheld in addition to these extra guidelines for commercial drivers |
| Persons with diabetes controlled by diet therapy alone or in combination with pills (oral hypoglycemic agents) are at low risk of hypoglycemia and can drive commercial vehicles as long as they receive annual medical exams and regular medical supervision (at least 2 clinic visits/year) as outlined in the private drivers guidelines. |
| Persons who require insulin to control their diabetes are subject to more rigorous evaluation in order to obtain and keep licenses to drive commercial vehicles |
| Supplies required to be carried at all times while driving include blood glucose monitoring equipment and a source of rapidly absorbable carbohydrate within easy reach in the vehicle. |
| Blood sugar must be tested within 1h before driving and every 4h while driving. |
| Driving should be stopped if blood sugar levels fall below 6.0 mmol/L while driving a commercial vehicle. |
| Driving should not be resumed until blood sugar levels have risen to > or = 6.0 mmol/L after food ingestion. |
Initial Application for a Commercial License
| Questionnaire to be completed by person with diabetes with emphasis on the risk (work schedule, insulin regimen, symptoms of hypoglycemia) and occurrence of hypoglycemia (frequency and severity in past 6 months) |
| An internist, endocrinologist, or family doctor trained in diabetes care must perform an initial complete assessment |
| applicant must supply evidence of attendance to a diabetes education program |
| applicant must present medical records from past 2 years and HbA1c measurement within past 3 months |
| applicant must have a dilated eye exam by an ophthalmologist or optometrist |
| applicant must have a log of blood sugars performed at least twice daily for the past 6 months or since the diagnosis of diabetes if onset occurred more recently than 6 months |
When are you not eligible to receive/maintain a commercial license?
| Severe hypoglycemia in past 6 months (loss of consciousness, seizure, or required help form someone else) |
| Hypoglycemia unawareness unless there has been documented recovery of warning symptoms at a later date |
| Uncontrolled diabetes: HbA1c > 12 % |
| Uncontrolled diabetes: > 10 % of capillary blood glucose levels in log < 4.0 mmol/L |
| Significant change in insulin regimen (recently started on insulin, new insulin type, change in number of injections) |
| Visual impairment (best eye must be at least 20/40) |
| High risk proliferative retinopathy |
| Peripheral neuropathy or cardiovascular disease with potential to affect driving |
| Inadequate record of self-monitoring of blood glucose (unreliable or absent measurements) |
| Inadequate knowledge of the causes, symptoms, and treatment of hypoglycemia |