Gill G, Durston J, Johnston R, MacLeod K, Watkins P
Department of Diabetes and Endocrinology, University Hospital Aintree, Liverpool, UK.
Diabet Med. 2002 Jun;19(6):435-9. doi: 10.1046/j.1464-5491.2002.00717.x.
Diabetes, and particularly insulin-treated diabetes, has important implications for motor vehicle driving, largely because of its association with potential hypoglycaemia. For this reason, most countries operate some driving restrictions on insulin-treated diabetic patients, as well as systems of intermittent reassessment of hypoglycaemic risk. In the UK, regulations are operated by the Driver and Vehicle Licensing Agency (DVLA), which is an agency of the Department of the Environment, Transport and the Regions (DETR). They are supported by an Expert Panel which advises the Secretary of State on diabetes-related issues relating to fitness to drive. The patient organization Diabetes UK is also concerned with diabetes and driving issues, largely from a position of lobbying policy-influencers and supporting individual cases. All parties involved with diabetes and driving issues recognize the need for more research on the subject, as the current literature is flawed in design, though no convincing excess of accidents amongst diabetic drivers has been conclusively demonstrated. Currently in the UK, Class 2 vehicles (large trucks and passenger vehicles) are barred to diabetic drivers on insulin. European law has recently extended this to so-called C1 (large vans and small lorries) and D1 (minibuses) vehicles, though the law has recently been revised to allow individual consideration for potential diabetic C1 drivers on insulin treatment. Diabetes and insulin-treated diabetes is an emotive and difficult issue, for which a stronger evidence base is urgently needed.
糖尿病，尤其是接受胰岛素治疗的糖尿病，对机动车驾驶有着重要影响，这主要是因为它与潜在的低血糖症相关。出于这个原因，大多数国家对接受胰岛素治疗的糖尿病患者实施了一些驾驶限制，以及对低血糖风险进行间歇性重新评估的系统。在英国，相关规定由驾驶员与车辆牌照局（DVLA）执行，该局是环境、运输与区域部（DETR）的一个机构。有一个专家小组为其提供支持，该小组就与驾驶适宜性相关的糖尿病问题向国务卿提供建议。患者组织英国糖尿病协会也关注糖尿病与驾驶问题，主要是从游说政策影响者和支持个别案例的角度出发。所有涉及糖尿病与驾驶问题的各方都认识到需要对该主题进行更多研究，因为当前的文献在设计上存在缺陷，不过尚未确凿证明糖尿病驾驶员中存在令人信服的事故过量情况。目前在英国，2类车辆（大型卡车和客车）禁止接受胰岛素治疗的糖尿病患者驾驶。欧洲法律最近已将此扩展到所谓的C1类（大型货车和小型货车）和D1类（小型巴士）车辆，不过该法律最近已修订，允许对接受胰岛素治疗的潜在糖尿病C1类驾驶员进行个别考虑。糖尿病以及接受胰岛素治疗的糖尿病是一个情绪化且棘手的问题，对此迫切需要更有力的证据基础。
