Medical Conditions and Driving: A Review of the Literature (1960 – 2000)
TRD Page
Foreword
Acknowledgements
Section1: Introduction
Section 2: Vision
Section 3: Hearing
Section 4: Cardiovascular
Section 5: Cerebrovascular
Section 6: Peripheral Vascular
Section 7: Nervous System
Section 8: Respiratory
Section 9: Metabolic
Section 10: Renal
Section 11: Musculoskeletal
Section 12: Psychiatric
Section 13: Drugs
Section 14: Aging Driver
Section 15: Anesthesia and Surgery
Appendix A
List of Tables
List of Figures
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Section 9: Metabolic Diseases

Hypothyroidism and Driving Literature Review

As noted previously, cognitive impairments, sleepiness, and fatigue associated with hypothyroidism have direct relevance for driving. In terms of research literature, the effects of hypothyroidism on cognitive functioning have received the most attention. Cognitive deficits associated with hypothyroidism include impairments in general intelligence (Haggerty, Evans, and Pringe, 1986; Mennemeier, Garner, and Heillman, 1993), attention and concentration (Osterweill, Syndulko, Cohen, et al., 1992), memory (Haggerty et al., 1986; Mennemeier et al., 1993), perceptual and visual functioning (Mennemeier et al., 1993; Osterweill et al., 1992), and executive/frontal lobe functioning (Mennemeier et al., 1993). It is interesting to note that many of the cognitive deficits associated with hypothyroidism do not show consistent improvement following treatment with thyroid hormone replacement therapy. It may, therefore, be important to test for cognitive deficits in individuals with hypothyroidism once they have been stabilized on thyroid hormone replacement therapy.

Table 29  Guidelines for Metabolic Diseases

(Reproduced with permission)

Guidelines for Metabolic Diseases (Drivers of Private Vehicles)

Illness

Austroads (1998)

CMA (2000)

Diabetes

Non-Insulin Treated Diabetes

Should not drive. The DLA will normally issue a conditional license if condition stable. Reviews of driving status will normally be required at intervals no greater than 5 years.

Can usually drive if:

  1. Has good understanding of condition.
  2. Follows instructions about diet, medication, and prevention of complications.
  3. Remains under regular supervision.

Insulin-Treated Diabetes

Should not drive. Normally, the DLA will issue conditional license on certificate of physician caring for the patient on the premise that the condition is stable and all other criteria (as per guidelines) have been met. Review of condition required at maximum period of 2 years.

Can drive if :

  1. Under regular medical supervision.
  2. Individual understands their diabetic condition and the close interrelationship between insulin demand, and diet and exercise.
  3. Follows physician’s advice
  4. No history of impairment due to alcohol or drug abuse.
  5. No history of severe hypoglycemic episodes in last 6 months.

Hyperthyroidism

May drive if stable and eligible under general vision criteria.

Patients with hyperthyroidism complicated by cardiac or neurologic symptoms should not drive any type of motor vehicle until the condition has been controlled.

Hypothyroidism

May drive if stable.

Patients with symptomatic hypothyroidism should not drive any type of motor vehicle until the condition has been brought under satisfactory control.

DLA = Driver Licensing Authority

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