What You Should Know about Diabetes

Dr. Paul McLemore D.C.
National Certified Medical Examiner

What is Diabetes


Type 1 diabetes Insipidus
Results from the failure to produce insulin. Usually a genetic factor you are born with. Requires Insulin use.

Type 2 diabetes Mellitus is the Most common
• You can produce insulin and have intact blood glucose control.
• Over time may require insulin replacement therapy.
• Results from insulin resistance, in which ****s fail to use insulin properly Or your pancreas is simply used up from years of sugar abuse.

“A person is physically qualified to drive a CMV if that person- Has no established medical history or clinical diagnosis of diabetes mellitus who currently requires insulin for control”

7.8% of US Population has diabetes
Diagnosed: 17.9 million
Undiagnosed: 5.7 million

Although management of hyperglycemia and hypoglycemia are important for overall health, the detection and management of hypoglycemia is more relevant to safe driving and certification of commercial drivers. (drivers may not be aware of hypoglycemic event)

Diabetes Advisory Criteria 49 CFR 391.41 (b) (3)
• Too many variables relating to use of insulin to regulate Diabetes (hypoglycemia, hyperglycemia).
• Have a higher risk of sudden incapacitation then non diabetics from hypo, and hyperglycemia; also may suffer changes in
vision, cognition, sensation and much more.
• Factors associated with long haul drivers especially often affect the diabetic.
• Therefore, the FMCSA has held that any individual who is an insulin dependent diabetic does not meet the criteria to drive a CMV.

Diabetes Factors of Driving a CMV that are relevant to glucose control:
• Fatigue
• Lack of Sleep
• Poor Diet
• Missed Meals
• Emotional Conditions
• Stress
• Fatigue
• Lethargy
• Sluggishness Ketoacidosis and hyperosmolar significantly impairs cognitive function but onset is gradual and frequency is generally low and onset recognizable by those with diabetes.
Other complications;
• Neuropathy
• Retinopathy
• Nephropathy

Diabetes may also cause accelerated atherosclerosis affecting coronary, cerebral and peripheral vessels which contributes to increased risk for Coronary Heart Disease.


Hypoglycemia

Hypoglycemia is the Most critical and challenging safety issue for diabetics. Can occur with/without use of insulin. May not be recognized to avoid loss or consciousness or coma.

Mild Hypoglycemia :
May Cause Rapid heart rate, Sweating, Weakness, Hunger

Severe Hypoglycemia : Symptoms that interfere with safe driving
May Cause Loss of consciousness , Need of assistance from another person, Period of impaired cognitive function that occurred without warning

A severe hypoglycemic reaction while driving endangers yourself and the public.


This information is collected from several instructional, institutional, medical, and educational sources. This should not be your sole source of information. Although I am a Nationally Certified Medical Examiner the answers for your particular situation is only my opinion and how I interpret the DOT Medical Exam process. You should discuss your particular situation with your Doctor and Medical Examiner.


Dr. Paul McLemore D.C.
National Certified Medical Examiner

Dr. Paul McLemore R.M.T., E.M.T., B.S., B.S., M.S., D.C.
Certified in acupuncture
Fax (940) 644-2067
Texas State Chiropractic License 8843
National DOT Medical Examiners Certificate 8404451981



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