Position statements - 15 September 2013
Austroads Assessing Fitness to Drive guidelines
In March 2012, Austroads and the National Transport Commission released their updated Assessing Fitness to Drive: Medical standards for licensing and clinical management guidelines.
The inclusion of a new Medical Standard for Licensing which requires people with diabetes to have an HbA1c level of less than 9.0% to be assessed as having ‘satisfactory control of diabetes’ (Section 3.3.2) has created concern, confusion and distress amongst people with diabetes, and in the diabetes community.
Following advocacy action by Diabetes Australia, the Transport and Infrastructure Senior Officials’ Committee (TISOC) approved changes to Assessing Fitness to Drive, March 2012 at a meeting in March 2013. The changes clarify the section that provides guidance on what the satisfactory control of diabetes means for driver licensing purposes.
However, Diabetes Australia believes that the clarifying statement does not go far enough. The new medical standards may lead to unfair and adverse outcomes for many people with diabetes. Diabetes Australia has raised these concerns with Austroads on numerous occasions and requested further amendment.
The remaining issues are:
- The definition of satisfactory control of diabetes as being an HbA1c of 9.0% or lower threatens to confuse the much more important issue of low blood glucose levels. Strong evidence shows that low blood glucose levels (hypoglycaemia), an unexpected hypoglycaemic episode and/or impaired hypoglycaemic awareness represent a much more serious risk to road safety.
- The intention of the medical standards was to trigger a further medical review of diabetes management in people with HbA1c greater than 9.0%. Instead, some people have simply (administratively) been denied eligibility for a license.
- The evidence base for including the HbA1c upper level of 9.0% is not strong. Many experts and other national jurisdictions do not accept that there is an association between high average blood glucose levels and driving risk.
Further information about these changes can be accessed on the Austroads website
www.austroads.com.au/assessing-fitness-to-drive/.
The updated version of Assessing Fitness to Drive for commercial and private vehicle drivers is now available for download from the Austroads website
www.austroads.com.au/images/stories/assessing_fitness_to_drive_2013.pdf
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