Managing Type 1 Diabetes: Paper Work and Other Details
The thought of one's child driving: liberating to some parents. Terrifying to others. Just plain worrisome to most.
I fall in the category of worried. Often likened to the character from the children's series Wemberly Worried, I too worry about nearly everything, which is not overly unusual for a parent. And I haven't even begun to worry about how my son's Type 1 diabetes could impact his safety - and other's - while he is behind the wheel of the car. I just plain shudder in general to think of him behind the wheel of a car.
However, the whole process is still a bit of a way's off for us. My son only recently turned fourteen, so has another year and a half (aged 15 years and 6 months to be exact here in the state of Virginia) before we can begin to think about the driving process. And, before he even puts the key into the ignition, he has another hurdle to jump applying for a learner's permit.
In most states, a learner's permit is required before someone embarks on learning to drive a car and then applies and tests for a driver's license. It can be applied for at a state's area Department of Motor Vehicles (DMV) or similar office. An applicant typically must fill in an application have his or her picture taken, pass an eye exam, and then also must take and pass a written exam. Getting the actual license often include having a minimum number of hours behind the wheel and passing a practical driving test.
In many states, though, a person who has Type 1 diabetes (and other conditions, like epilepsy that can impair judgment) must take additional steps, whether it be when applying for a learner's permit or for a driver's license. On one of these applications (and this depends on which state) an application will ask outright if a person has a condition that will impact their driving abilities. We live in Virginia, and applicants for driver's licenses (not learner's permits) are asked if they "have a physical or mental condition which requires [them] to take medication?" and then to explain in a separate box what the medical condition is.
Once this medical condition has been noted, the applicant must get a medical statement from his or her doctor or nurse practitioner to send to the state's Medical Review Board before applying for the permit or license. These forms often can be found online at the state's DMV site (for an example, you can click here to the Virginia site and forms. Once completed by the applicant and the doctor/nurse practitioner, the forms are then reviewed by the state's medical review board. It will vary from state to state whether and how much a medical review board gets involved.
A good resource is a report published in 2003 by The American Association of Motor Vehicle Administrators and the National Highway Traffic Safety Administration entitled "Summary of Medical Advisory Board Practices in the United States." This report includes a section on each state with extensive information about the state's medical review program, including procedures and medical guidelines.
For example, the process of the medical review in Virginia, which includes the need to review applicants for insulin-dependent diabetics, requires that applicants have their practitioners fill out a medical report within 90 days of application. The practitioner then must provide the Medical Review Board with the following information in the report: the applicant's diagnosis, report of if the patient has been hospitalized as a result of the diagnosis, a list any medicines that are prescribed, if the applicant follows the treatment regiment, and finally an opinion as to whether the applicant is "medically capable of operating a vehicle."
As with so much with this condition, it can't hurt to do additional research so that you know what may be expected of you or your T1 teenager when applying either for a learner's permit or driver's license. Start with your state's DMV or equivalent, because the process varies. And, if you have problems with the process at any time and feel that you, or your child need an advocate, consider contacting the American Diabetes Association at 1-800-DIABETES.
And, try not to worry.