Ministry of Transportation Ontario (MTO)
Diabetes Assessment Form for Private Drivers with Diabetes
– Frequently Asked Questions -
1. I have been driving for years and have never been asked to submit information about my diabetes. Why am I being asked to submit information now? In an effort to streamline internal processes and bring reporting requirements for diabetes in line with other medical conditions, and in response to recommendations made by the Ontario Ombudsman in his April 2014 report, Better Safe than Sorry, the Ministry of Transportation has reviewed its medical reporting requirements to ensure that all drivers meet national medical standards for driver fitness. 2. What are the new licence application and renewal requirements for private drivers with diabetes in Ontario? At license application, drivers who report diabetes using insulin will proceed with their licence application per current practice. These drivers will then be contacted by the Ministry’s Medical Review Section and will be required to submit a Diabetes Assessment Form completed by their physician or nurse practitioner. Provided the assessment confirms that national medical standards are met no further information will be required. At license renewal, drivers with diabetes will proceed with their renewal per current practice. If there is no prior diabetes assessment form on file these drivers will then be contacted by the Ministry’s Medical Review Section and will be required to submit a Diabetes Assessment Form completed by their physician or nurse practitioner if they report Diabetes using insulin or Diabetes (without providing any further detail). Provided the assessment confirms that national medical standards are met no further information will be required. Drivers who manage their diabetes by diet/lifestyle or with oral medication are not required to complete a Diabetes Assessment Form. 3. Will I be required to submit information about my diabetes management every time I renew my license? No; once a completed Diabetes Assessment Form has been submitted and it is confirmed that national medical standards are met, additional reports should not be required. Additional medical information will be required, however, if a driver is reported by a physician, nurse practitioner or the police. 1 4. Who is permitted to complete the Diabetes Assessment Form? The diabetes assessment form can be completed by your family physician, nurse practitioner or diabetes specialist. 5. How does the Ministry assess my fitness to drive? Medical reports are assessed against Canadian Council of Motor Transport Administrators (CCMTA) national medical standards. The CCMTA standards are used by licensing authorities across Canada to assess driver fitness. These standards show the link between medical conditions, adverse driving outcomes and affect on functional ability. They stress not just medical standards but individual assessment. The Ministry has a variety of condition specific forms including Epilepsy & Seizures, Cognitive Impairment, Mental Health, Cerebrovascular Disease/Brain Injury and Other Neurological Diseases, Cardiological Assessment, Substance Abuse, and Diabetes; these forms collect necessary information to determine national medical standards for driving are met. When making a decision to report a patient to the Ministry, many physicians look to the Canadian Medical Association’s Determining Medical Fitness to Operate Motor Vehicles. Recommendations in this guide are based on the Canadian Diabetes Association’s Guidelines for Diabetes and Private and Commercial Driving and the Canadian Diabetes Association’s Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Recommendations for all drivers with diabetes include the following:  Have a good understanding of their condition;  Follow physician’s instructions about diet, medication, blood glucose monitoring and hypoglycemia prevention;  Remain under regular medical supervision to ensure that any progression in condition or development of chronic complications does not go unattended;  Do not drive when glucose level is below 4.0 mmol/L and do not begin to drive without prophylactic carbohydrate treatment when glucose levels are between 4.0 and 5.0 mmol/L;  Stop driving and treat if hypoglycemia (low blood sugar) is identified or suspected;  Do not drive until at least 45 minutes after effective treatment if glucose level is between 2.5 ‐ 4.0 mmol/L;  When on long drives, tests blood glucose immediately before driving and approximately every 4 hours while driving and have an available sources of rapidly absorbable glucose;  Always carry blood glucose monitoring equipment and supplies of rapidly absorbable carbohydrate treatment within easy reach. 2 6. What is the Canadian Diabetes Association’s position on diabetes and licensing? People with diabetes have the right to be assessed for a license to drive a motor vehicle on an individual basis in accordance with the Canadian Diabetes Association’s guidelines for private and commercial driving. 3