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Drivers With Diabetes Innocent Until Proven Guilty

Individuals who have diabetes face a multitude of state and federal regulations on motor vehicle licensing and certification. Currently, most people with diabetes are deemed medically capable of operating a private automobile. However, those using insulin for the treatment of diabetes are not permitted to operate large trucks in interstate commerce and often are not allowed to drive buses or emergency vehicles. The use of insulin automatically excludes an individual from being certified as an interstate truck driver, independent of his/her qualifications to drive. Such blanket restrictions on motor vehicle operation limit the employment and economic opportunities available for individuals with diabetes. The review by Ratner and Whitehouse (this issue, p. 217) detailed the outcome of a recent conference on diabetes and commercial driving. The conference was developed with the intent of changing the restrictions for truck driver certification. In this congress, representatives from the American Diabetes Association argued that insulin-treated diabetic (ITDM) drivers should not be summarily rejected as a group on a medical basis but should be reviewed by their qualifications, both medical and operational, on an individual basis. The conference recommendations produced the conservative guidelines that only a few ITDM drivers [those currently employed in the industry, with type II (non-in-