In 1971, the U.S. Supreme Court held in Bell v. Burson that driving is an "important interest" that may not be taken away from a licensed driver without a government agency's providing procedural due process.
For a person with diabetes the prospect of going into a hypo while driving is frightening at the least. On the evening of June 12, this is exactly what happened to 34-year-old Virginia resident Tom Moore, who was plunged into a bizarre series of events as a result.
Dr. Arthur Neumann, a retired physician, has lived with diabetes since 1951. He awoke at 4:00 a.m. one morning suffering from a severe hypoglycemic attack and within minutes blacked out. Luckily, his companion was there to inject him with a shot of glucagon-a solution which raises blood sugar by forcing the liver to release stored glucose. Naturally, Neumann reported the incident to his doctor.
The American Diabetes Association has suggested a series of medical prerequisites for all commercial vehicle waiver applicants. The prerequisites are intended to ensure that people with diabetes who are issued waivers "will not be contrary to public interest and will be consistent with the safe operation of commercial vehicles." The conditions, listed below, focus on applicants' ability to prove they do not suffer from severe hypoglycemia, hypoglycemic unawareness, or retinopathy, and to demonstrate their willingness and capability to properly monitor and manage their disease.
In contrast to European governments, which have progressively restricted driving permits for individuals with insulin-dependent diabetes, the United States has been far more liberal in its restrictions. In an attempt to determine the decline in driving capability by insulin dependent adults experiencing hypoglycemia, the University of Virginia's General Clinical Research Center conducted a study of twenty five adults, measuring both their driving performance as well as their awareness of their driving performance during and after artificially-induced episodes of hypoglycemia. The study participants were infused with intravenous regular insulin, administered to produce mild and moderate hypoglycemic reactions, while they drove high-tech driving simulators. Immediately before and after each test, the participants were asked: "Would you choose to drive right now? Yes/No." The participants were kept shielded from their blood glucose levels throughout the tests.
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