Diabetes and driving safety: A survey among health care professionals in Saudi Arabia


      • We explore HCPs’ knowledge of problems associated with diabetes and driving.
      • We evaluate the consistency of counseling on safety for drivers with diabetes.
      • We conducted a cross-sectional survey-based study among HCPs in Saudi Arabia.
      • Only 5.7% of HCPs correctly answered all the driving safety questions.
      • Only 12.6% of HCPs always counseled their patients about driving safety.



      Diabetes mellitus may impair an individual’s fitness to drive. In this study, we explore health care providers’ (HCPs) knowledge of problems associated with diabetes and driving, and evaluate the consistency of counseling on driving safety for patients with diabetes.


      We conducted a cross-sectional survey-based study among HCPs in Saudi Arabia. We designed a web-based questionnaire to collect demographic data, assess HCPs’ knowledge of driving and diabetes and their compliance with driving safety regulations, and meet Diabetes Canada’s and the British Driver and Vehicle Licensing Agency’s recommendations. Data were analyzed using descriptive statistics and chi-square analysis.


      We received 389 responses to the questionnaire. The majority of the respondents were consultants (38.8%), worked in governmental institutes (72.2%), and managed more than 30 patients weekly (34.4%). Only 5.7% of HCPs correctly answered all the driving safety questions. Diabetes educators and general practitioners had the fewest correct answers (p-value 0.03).
      About 12.6% of HCPs stated that they always counseled their patients about driving safety strategies.


      HCPs’ education in problems associated with diabetes and driving should be improved to ensure quality counseling for their patients.


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        • Guariguata L.
        • Whiting D.R.
        • Hambleton I.
        • Beagley J.
        • Linnenkamp U.
        • Shaw J.E.
        Global estimates of diabetes prevalence for 2013 and projections for 2035.
        Diabetes Res. Clin. Pract. 2014; 103: 137-149https://doi.org/10.1016/j.diabres.2013.11.002
        • El Bcheraoui C.
        • Basulaiman M.
        • Tuffaha M.
        • Daoud F.
        • Robinson M.
        • Jaber S.
        • Mikhitarian S.
        • Memish Z.A.
        • Al Saeedi M.
        • AlMazroa M.A.
        • Mokdad A.H.
        Status of the diabetes epidemic in the Kingdom of Saudi Arabia, 2013.
        Int. J. Public Health. 2014; : 1011-1021https://doi.org/10.1007/s00038-014-0612-4
      1. International diabetes federation MENA Members, (n.d.). https://idf.org/our-network/regions-members/middle-east-and-north-africa/members/46-saudi-arabia.html (Accessed 16 May 2021).

        • Houlden R.L.
        • Berard L.
        • Lakoff J.M.
        • Woo V.
        • Yale J.F.
        Erratum to “Diabetes and Driving”: Canadian Journal of Diabetes 2018;42(S1):S150-S153 (Canadian Journal of Diabetes (2018) 42(S1) (S150–S153), (S1499267117308286) (10.1016/j.jcjd.2017.10.018)).
        Can. J. Diabetes. 2018; 42: 576https://doi.org/10.1016/j.jcjd.2018.08.196
        • Cox D.J.
        • Singh H.
        • Lorber D.
        Diabetes and driving safety: science, ethics, legality and practice.
        Am. J. Med. Sci. 2013; 345: 263-265https://doi.org/10.1097/MAJ.0b013e31828bf8d7
        • Gold A.E.
        • MacLeod K.M.
        • Deary I.J.
        • Frier B.M.
        Hypoglycemia-induced cognitive dysfunction in diabetes mellitus: effect of hypoglycemia unawareness.
        Physiol. Behav. 1995; 58: 501-511https://doi.org/10.1016/0031-9384(95)00085-W
        • Min T.
        Driving and insulin-treated diabetes CVD risk and bariatric surgery View project, Artic.
        J. Diabetes Nurs. 2015; 19 (https://www.researchgate.net/publication/280729989 (Accessed 16 May 2021)): 254-259
        • Cox D.J.
        • Gonder-Frederick L.A.
        • Kovatchev B.P.
        • Julian D.M.
        • Clarke W.L.
        Progressive hypoglycemia’s impact on driving simulation performance: occurrence, awareness, and correction.
        Diabetes Care. 2000; 23: 163-170https://doi.org/10.2337/diacare.23.2.163
        • Arici B.
        Diabetes, hypoglycemia and driving instructions in Switzerland.
        Ther. Umschau. 2020; 77: 328-332https://doi.org/10.1024/0040-5930/a001199
        • Weinger K.
        • Kinsley B.T.
        • Levy C.J.
        • Bajaj M.
        • Simonson D.C.
        • Cox D.J.
        • Ryan C.M.
        • Jacobson A.M.
        The perception of safe driving ability during hypoglycemia in patients with type 1 diabetes mellitus.
        Am. J. Med. 1999; 107: 246-253https://doi.org/10.1016/S0002-9343(99)00221-1
        • Stork A.D.M.
        • Van Haeften T.W.
        • Veneman T.F.
        The decision not to drive during hypoglycemia in patients with type 1 and type 2 diabetes according to hypoglycemia awareness.
        Diabetes Care. 2007; 30: 2822-2826https://doi.org/10.2337/dc06-1544
        • Cox D.J.
        • Ford D.
        • Gonder-Frederick L.
        • Clarke W.
        • Mazze R.
        • Weinger K.
        • Ritterband L.
        Driving mishaps among individuals with type 1 diabetes: a prospective study.
        Diabetes Care. 2009; 32: 2177-2180https://doi.org/10.2337/dc08-1510
        • A.D. Association
        Diabetes and driving.
        Diabetes Care. 2013; 36: S80-S85https://doi.org/10.2337/dc13-S080
        • Beshyah S.A.
        • Beshyah A.S.
        • Yaghi S.
        • Beshyah W.S.
        • Frier B.M.
        A global survey of licensing restrictions for drivers with diabetes.
        Br. J. Diabetes Vasc. Dis. 2017; 17: 3-10https://doi.org/10.15277/bjd.2017.117
      2. Diabetes Canada, Clinical Practice Guidelines - Full Guidelines, (n.d.). http://guidelines.diabetes.ca/cpg (Accessed 16 May 2021).

      3. Diabetes and driving - GOV.UK, (n.d.). https://www.gov.uk/diabetes-driving (Accessed 16 May 2021).

        • Aldossari K.K.
        • Aldiab A.
        • Al-Zahrani J.M.
        • Al-Ghamdi S.H.
        • Abdelrazik M.
        • Batais M.A.
        • Javad S.
        • Nooruddin S.
        • Razzak H.A.
        • El-Metwally A.
        Prevalence of prediabetes, diabetes, and its associated risk factors among males in Saudi Arabia: a population-based survey.
        J. Diabetes Res. 2018; 20182194604https://doi.org/10.1155/2018/2194604
        • Almigbal T.H.
        • Alfaifi A.A.
        • Aleid M.A.
        • Billah B.
        • Alramadan M.J.
        • Sheshah E.
        • AlMogbel T.A.
        • Aldekhayel G.A.
        • Batais M.A.
        Safe driving practices and factors associated with motor-vehicle collisions among people with insulin-treated diabetes mellitus: results from the Diabetes and Driving (DAD) study.
        J. Saf. Res. 2018; 65: 83-88https://doi.org/10.1016/j.jsr.2018.03.003
        • Min T.
        • Younis N.
        • Dixon A.N.
        Insulin-treated diabetes: awareness and adherence to driving recommendations.
        Pract. Diabetes. 2015; 32 (206–206)https://doi.org/10.1002/pdi.1958
        • Inkster B.
        • Pooley D.
        • De Saxe H.
        • Ashraf M.
        • Frier B.M.
        Blood glucose testing by drivers with diabetes: a survey of glucose meter users.
        Br. J. Diabetes Vasc. Dis. 2015; 15: 20-23https://doi.org/10.15277/bjdvd.2015.003
        • Moniz C.
        • Ferreira R.
        • Serra F.
        • Fonseca R.
        • Vasconcelos C.
        • Saraiva A.M.
        Driving with diabetes: what is the Portuguese doctors’ and patients’ knowledge?.
        Rev. Port. Endocrinol. Diabetes Metab. 2015; 10: 14-17https://doi.org/10.1016/j.rpedm.2014.07.003
        • Fruehwald-Schultes B.
        • Born J.
        • Kern W.
        • Peters A.
        • Fehm H.L.
        Adoptation of cognitive function to hypoglycemia in healthy men.
        Diabetes Care. 2000; 23: 1059-1066https://doi.org/10.2337/diacare.23.8.1059
        • Batais M.A.
        • Alamri A.K.
        • Alghammass M.A.
        • Alzamil O.A.
        • Almutairi B.A.
        • Al-Maflehi N.
        • Almigbal T.H.
        Diabetes and driving recommendations among healthcare providers in Saudi Arabia: a significant gap that requires action.
        Saudi Med. J. 2018; 39: 386-394https://doi.org/10.15537/smj.2018.4.22179
        • Petrosyan L.
        • Ghazaryan Z.
        • Muradyan G.
        • Aghajanova E.
        • Brabece M.
        • Žďárská D.J.
        • Halčiakova K.
        • Polák J.
        • Frier B.M.
        • Brož J.
        Limited knowledge of safe driving practice among drivers with diabetes in Armenia: association with greater risk of motor vehicle accidents.
        J. Diabetes Mellit. 2019; 09: 14-23https://doi.org/10.4236/jdm.2019.91002
        • Babineaux S.M.
        • Toaima D.
        • Boye K.S.
        • Zagar A.
        • Tahbaz A.
        • Jabbar A.
        • Hassanein M.
        Multi-country retrospective observational study of the management and outcomes of patients with type 2 diabetes during Ramadan in 2010 (CREED).
        Diabet. Med. 2015; 32: 819-828https://doi.org/10.1111/dme.12685
      4. Canada Day… by the numbers, (n.d.). https://www.statcan.gc.ca/eng/dai/smr08/2017/smr08_219_2017 (Accessed 11 April 2021).

      5. Population Projections for Canada and its Regions, 2011 to 2036, (n.d.). https://www150.statcan.gc.ca/n1/pub/91-551-x/91-551-x2017001-eng.htm (Accessed 15 April 2021).

        • Ghouri N.
        • Hussain S.
        • Mohammed R.
        • Beshyah S.A.
        • Chowdhury T.A.
        • Sattar N.
        • Sheikh A.
        Diabetes, driving and fasting during Ramadan: the interplay between secular and religious law.
        BMJ Open Diabetes Res. Care. 2018; 6: 520https://doi.org/10.1136/bmjdrc-2018-000520
        • Al Azawi L.
        • O’byrne A.
        • Roche L.
        • O’neill D.
        • Ryan M.
        Inclusion of medical fitness to drive in medical postgraduate training curricula.
        J. R. Coll. Physicians Edinb. 2020; 50: 309-315https://doi.org/10.4997/JRCPE.2020.322
        • Choudhary D.
        • Brown B.
        • Albokhari D.
        • Elfadil S.
        • Khawar N.
        • Narula P.
        • Agdere L.
        The use of a diabetes electronic medical record template leads to consistent improvement of screening for complications of type 1 diabetes mellitus.
        Pediatrics. 2018; 142 (616–616)https://doi.org/10.1542/PEDS.142.1_MEETINGABSTRACT.616
        • Lega I.C.
        • McLaughlin H.
        • Coroneos M.
        • Handley-Derry F.
        • Donovan N.
        • Lipscombe L.L.
        A physician reminder to improve postpartum diabetes screening in women with gestational diabetes mellitus.
        Diabetes Res. Clin. Pract. 2012; 95: 352-357https://doi.org/10.1016/j.diabres.2011.10.023