RoSPA's response to consultation on allowing bus and lorry drivers with diabetes to use Continuous Glucose Monitoring Systems.

At RoSPA, we are committed to improving road safety for everyone, and we are pleased to have had the opportunity to respond to the DVLA’s consultation on a proposal to allow bus and lorry drivers with diabetes to use Continuous Glucose Monitoring Systems (CGMS) while driving.

A Continuous Glucose Monitoring System (CGMS) is a device that continuously tracks the level of glucose (sugar) in a person's blood throughout the day and night. Unlike traditional blood glucose meters, which require finger-prick tests to measure blood sugar at specific moments, CGMS provide real-time, continuous readings. This helps individuals with diabetes manage their blood glucose levels more effectively. This change has the potential to enhance safety on the roads and improve the management of diabetes for professional drivers.

Why we support continuous glucose monitoring for drivers

We fully support the introduction of CGMS for Group 2 drivers—those who operate buses, lorries, and other large vehicles. Here’s why:

• Real-time monitoring: CGMS provide continuous monitoring of glucose levels, which is far more effective than the traditional finger-prick test. It allows drivers to stay on top of their blood glucose levels while driving, reducing the risk of dangerous hypoglycaemic (low blood sugar) or hyperglycaemic (high blood sugar) episodes.
• Predictive alerts: One of the most significant benefits of CGMS is their ability to send predictive alerts when a driver’s glucose levels are approaching unsafe thresholds. These early warnings enable drivers to take corrective actions before a medical emergency occurs, greatly reducing the risk of accidents.
• Improved control and safety: Research has shown that CGMS can help drivers maintain better glucose control, keeping them out of the dangerous lows or highs that can impair their ability to drive safely. This enhances the safety of not just the driver, but everyone on the road.
• User-friendly and convenient: CGMS are more convenient than regular finger-prick testing, which requires more time and can be disruptive during long hours of driving. It also encourages more frequent monitoring, which is crucial for effective diabetes management.

Training and support are key to success

While we are enthusiastic about the potential benefits of CGMS, we believe that proper training and support will be essential for ensuring the system’s effectiveness. Simply providing drivers with the technology is not enough. Here’s why:
 

• Training on how to use CGMS: Drivers will need training to ensure they understand how to use the device and interpret the data it provides. Misunderstanding or misusing the system could lead to poor decision-making and, ultimately, unsafe driving.
• Support for real-world challenges: We recognise that using CGMS in real-world settings can be challenging. Issues like device discomfort, skin reactions, and technical difficulties may arise, which could discourage some drivers from using the system effectively. Therefore, it’s vital that drivers receive ongoing support to address these challenges and help them stay comfortable with the system.

Potential challenges to consider

While CGMS are a promising development, we also want to highlight some potential challenges that need to be addressed:
 

• Cost: CGMS devices and sensors are more expensive than traditional testing methods. There could be financial implications for drivers or employers, particularly if the devices are not covered by insurance or healthcare schemes.
• Device reliability: Although CGMS are generally accurate, there is a risk that the device may malfunction or provide inaccurate readings. This could result in drivers making decisions based on faulty information, which could compromise safety.
• Training needs: Not all drivers are comfortable with new technology, so it’s essential that they receive proper training and support. Without this, some drivers may struggle to use the system effectively, potentially putting themselves and others at risk.
• Over-reliance on technology: While CGMS can be a great tool, we caution against over-relying on the technology. Drivers must remain alert to their own physical symptoms of hypoglycaemia, even when the device is not alarming. If drivers ignore or dismiss physical warning signs in favour of the technology, it could be dangerous.

A holistic approach to driver health

At RoSPA, we believe that CGMS should be part of a wider focus on the overall health of drivers, especially given the sedentary nature of long-haul driving. Conditions like obesity, cardiovascular disease, and mental health issues can all affect a driver’s ability to manage diabetes effectively and their overall road safety.

That’s why, in addition to supporting the use of CGMS, we advocate for a more comprehensive approach to driver health that includes:
 

• Encouraging physical activity: Long hours spent sitting in a vehicle can lead to poor health. Promoting exercise and physical activity for drivers is essential for maintaining good overall health.
• Health checks: Regular health checks can help identify any underlying issues that may affect a driver’s safety and wellbeing.
• Healthy lifestyle choices: Drivers should be supported in making healthy lifestyle choices, such as eating well and managing stress, to improve their overall health and reduce the risk of diabetes-related complications.

Conclusion

RoSPA welcomes the proposal to allow CGMS for Group 2 drivers and believes it could have a positive impact on road safety and diabetes management. However, for this technology to be fully effective, we emphasise the need for proper training, support, and a holistic approach to driver health.

We thank the DVLA for the opportunity to participate in this consultation and look forward to seeing continued efforts to improve road safety and support drivers in managing their health.

RoSPA is happy for this response to be reproduced or attributed.