A 21-year-old woman with type 1 diabetes visits your pharmacy; She is driving a long 6-hour drive tomorrow. Which is the MOST appropriate advice for this patient?

• A. Ensure she maintains her glucose levels at 5 mmol or more during the journey
• B. Increase carbohydrate intake during the journey
• C. Do not test her glucose during the journey
• D. Stop testing during the journey

Answer: (A)

Preventing hypoglycemia is key when driving, especially for someone with type 1 diabetes on a long journey. Keeping glucose at or above about 5 mmol/L (90 mg/dL) before starting and then monitoring during the trip helps ensure the brain has enough glucose and reduces the risk of impaired driving, accidents, or becoming unable to continue safely. Plan to test glucose before you drive and at intervals during the six hours, and carry fast-acting carbohydrates to treat any drop quickly. Simply increasing carbohydrate intake without checking levels may still leave you below the safe threshold, and not testing (or stopping testing) during the journey is dangerous because hypoglycemia can develop without warning.