Drivers & Diabetes
January 1, 2011
One of the most common problems the St. Christopher Fund sees is a driver being taken off the road for new onset or uncontrolled diabetes. In 2006, diabetes was the 7th leading cause of death in the U.S. According to the Centers for Disease Control (CDC), in 2008, 7.8% (23.6 million) of the population were diabetic. An additional 57 million were considered pre-diabetic. Those with pre-diabetes are at a 50% increased risk of heart disease and stroke.
Risk factors for diabetes include:
• Over age 45
• Family history of diabetes
• Low HDL cholesterol
• High triglycerides
• High blood pressure
• African Americans, Hispanic/Latino Americans, Asian Americans, Pacific Islanders, American Indians, and Alaska Natives are at greater risk
• Women who had gestational diabetes
• Those with impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG)
The majority of people with diabetes (90-95%) have Type 2 diabetes. According the CDC, you can reduce your rate of Type 2 diabetes by 58% if you exercise 30 minutes a day, 5 days/week and loose 5-7% of your weight. Physical activity is important because it will help control your weight, your glucose level and your blood pressure. However, you should not exercise if your glucose level is below 100, above 300, or your fasting glucose is above 250. It is important to check your levels after exercise to see how they were affected.
The American Diabetes Association now recommends that physicians test, diagnose and treat diabetes based on hemoglobin A1c levels, as opposed to previously used glucometer testing. The reason for this shift is that A1c testing does not have to be fasting and it provides a 2-3 month average blood glucose level instead of a snapshot level as in urine sugar and glucometer testing. The value of this shift is that drivers’ jobs can be saved. Prior to A1c testing, drivers with elevated glucometer readings would have been taken off the road for 2-14 days, and even longer in a newly diagnosed diabetic. The A1c test provides are more reliable measure of glucose levels. Therefore, it would be wise to ask for an A1c test instead of a glucometer or urine test at your next physical.
A normal hemoglobin A1c is between 4-6. For those with diabetes, you should aim to keep your A1c below 7. The higher your A1c, the higher your risk of complications related to diabetes such as heart disease, stroke, high blood pressure, blindness, kidney disease, nervous system disease and amputation. The CDC and ADA have reported that a 1% drop in A1c levels reduce the incidence of kidney failure, retinopathy and nerve damage by 40%.
As with most of the medical problems seen by the St. Christopher Fund, diabetes can be prevented by maintaining a healthy weight, abstaining from tobacco use, being aware of your risk factors and doing something about them.
• Need help developing healthy meal plans to control or prevent diabetes? If so, visit www.eatright.org to find a nutrition professional to help you.
• Need information about diabetes and how it affects you? Visit www.diabeteseducator.org to get in touch with a diabetes educator who can answer your questions.
• The American Diabetes Association has many more valuable resources on their website (www.diabetes.org) such as MyFoodAdvisor, which helps you keep track of meals, find recipes and healthier food alternatives.
• Suggested reading: 8 weeks to Maximizing Diabetes Control