Driving with Diabetes
Being able to drive supports connection — to whānau, work, marae, and community. For many New Zealanders, especially in rural areas, driving is essential to daily life and independence. People living with diabetes have the same right to safe and equitable mobility, supported by fair systems and culturally safe care.
Understanding Diabetes and Driving
Both Type 1 and Type 2 diabetes can affect driving safety, especially when blood glucose levels fluctuate. The key concern for regulators is hypoglycaemia (low blood glucose), which can impair reaction times, concentration, and decision-making. For people with Type 2 diabetes, complications such as vision changes or neuropathy may also affect fitness to drive.
The goal is not exclusion, but ensuring drivers are safe, informed, and supported to manage their diabetes confidently.
New Zealand Transport Agency (NZTA) Requirements
Private Driver Licences (Class 1 & 6)
Most people with diabetes — including those using insulin — can hold and renew a private licence.
Requirements:
- Declare diabetes at licence renewal.
- Must not have had severe hypoglycaemia (requiring assistance) within the past year.
- Must have adequate hypoglycaemia awareness and be under regular medical care.
- Eyesight and limb function must meet standard NZTA criteria.
Recommended practices:
- Check blood glucose before driving (and at regular intervals for longer trips).
- Avoid driving if below 5 mmol/L — follow “5 to Drive” guidance.
- Keep glucose treatment and a blood glucose meter or CGM visible and accessible.
- Use continuous glucose monitoring (CGM) with alerts where possible.
Commercial Licences (Class 2–5, P, V, I, O endorsements)
Commercial drivers (truck, bus, taxi, heavy vehicle, passenger endorsements) face stricter requirements.
Key standards:
- Must undergo annual medical assessment by a GP or specialist.
- If using insulin, must show:
- No severe hypoglycaemia in the previous year.
- Good awareness of low blood glucose symptoms.
- Stable glucose management and documented specialist review.
- If not using insulin (diet or oral meds only), review is less intensive.
Decisions are made case-by-case in line with NZTA’s Medical Aspects of Fitness to Drive guidelines (2022).
Other Transport Contexts
| Mode | Guidance |
| Air travel | Carry insulin and technology in hand luggage; temperature-proof storage; travel letter from clinician. For pilots, insulin-treated diabetes currently precludes commercial aviation but may permit recreational flying under strict medical oversight. |
| Sea travel / Diving | Commercial diving restricted for insulin users; recreational diving may be permitted with specialist clearance and clear self-management plan. |
| Public transport | Always carry hypo treatment and ID. If issues arise (e.g. hypo on bus/train), staff should respond with basic first aid, not exclusion. |
| Cycling / Micromobility | Same safety steps as for driving — monitor glucose, wear ID, plan routes safely. |
| Rural & remote transport | Te Whatu Ora and regional councils should consider diabetes-safe emergency and transport planning for isolated communities, especially for insulin access and cold-chain maintenance. |
Technology and Safe Driving
Newly funded CGM systems (as of 2024) make safe driving easier. Continuous glucose data with high/low alerts supports self-monitoring without distraction.
Recommended features:
- Hypo alerts set above 4.5 mmol/L.
- “Driving mode” or silent alerts to reduce distraction.
- Sync to car displays or phones where safe and legal.
People using pumps or CGMs should have secure placement to avoid line tugs or disconnections during seatbelt use.
Practical Steps for Drivers
- Always check before driving – “5 to Drive” (≥5 mmol/L).
- Carry glucose within reach.
- Wear diabetes ID (bracelet, card, or phone lock screen).
- Stop immediately if feeling low; treat and wait until levels stabilise.
- Plan longer journeys with scheduled stops and meals.
- Maintain regular eye checks and foot care.
- Inform your clinician if you’ve had a severe hypo while driving — early support avoids licence issues.
Your Rights and Responsibilities
- Having diabetes does not automatically disqualify you from holding a licence.
- Medical reviews should be fair, timely, and affordable.
- You have the right to appeal a medical fitness decision (via NZTA reassessment).
- Employers must not discriminate against licensed drivers with diabetes.
Page updated: September 2025
| LEGAL DISCLAIMER: The information on this website is provided for general educational purposes only and is intended for a New Zealand audience. It is not a substitute for professional medical advice, diagnosis, or treatment. While I strive to ensure accuracy and relevance, please always seek guidance from your healthcare provider for personal medical decisions. Use of the content is at your own risk. Links to other sites are for convenience and do not imply endorsement. |
