3.3 Medical standards for licensing

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1 DIABETES MELLITUS Gestational diabetes mellitus The standards in this chapter apply to diabetes mellitus as a chronic condition. The self-limiting condition known as gestational diabetes mellitus (GDM) does not impact on licensing. However, consideration should be given to short-term fitness to drive in women with GDM treated with insulin, although severe hypoglycaemia in this setting is rare. Affected persons should be counselled to recognise symptoms and to restrict driving when symptoms occur. 3.3 Medical standards for licensing Medical requirements for unconditional and conditional licences are outlined in the table on pages 60 and Diabetes treated by glucose-lowering agents other than insulin Private vehicle drivers treated by glucose-lowering agents other than insulin may generally drive without licence restriction (i.e. on an unconditional licence) but should be required by the driver licensing authority to have five-yearly reviews. Commercial vehicle drivers in this situation are required to have at least annual specialist review to monitor progression of their condition Satisfactory control of diabetes When assessing whether the criteria for a conditional licence are met, for the purposes of the assessment diabetes can generally be considered to be satisfactorily controlled if there is a glycated haemoglobin (HbA1c) level of less than 9.0% (75 mmol/mol) measured within the preceding three months, as against a general goal of less than 7.0% in people with diabetes. A HbA1c level of 9.0% or higher should usually trigger a formal consultation and assessment by a specialist or clinician experienced in the management of diabetes, in order to assess fitness to drive. For people on insulin treatment, blood glucose monitoring records and other related records should also be reviewed. In general for commercial vehicle drivers on insulin, at least the last three months of blood glucose monitoring records should be reviewed, whilst for private vehicle drivers on insulin, records of blood glucose monitoring across recent months should be reviewed Recommendation and review of conditional licences for commercial vehicle drivers It is a general requirement that conditional licences for commercial vehicle drivers are issued by the driver licensing authority based on advice from an appropriate medical specialist, and that these drivers are reviewed periodically by the specialist to determine their ongoing fitness to drive (refer to Part A section 3.4 Conditional licences). In the case of type 2 diabetes managed by metformin alone, ongoing fitness to drive may be assessed by the treating general practitioner by mutual agreement with the treating specialist. The initial recommendation of a conditional licence must, however, be based on the opinion of a specialist in diabetes. Part B: 3 58

2 Appendix 8: Driver licensing authority contacts (as at March 2013) GENERAL CONTACT DETAILS DRIVER LICENSING AUTHORITY HEALTH PROFESSIONAL ENQUIRIES n Capital Road User Services PO Box 582 Dickson ACT 2602 Phone: rus@act.gov.au Web: Licensing and Registration Team Road User Services PO Box 582 Dickson ACT 2602 Phone: (02) New South Wales Roads and Maritime Services NSW Locked Bag 928 North Sydney NSW 2059 Phone: Fax: RTA.Contact.Centre@rms.nsw.gov.au Web: Manager Licence Review Unit RMS Driver Administration Section Locked Bag 14 Grafton NSW 2460 Phone: (02) Fax: (02) RTA.Contact.Centre@rms.nsw.gov.au Northern Queensland Manager Motor Vehicle Registry GPO Box 530 Phone: / (08) Fax: (08) mvr@nt.gov.au Web: and Main Roads GPO Box 2451 Brisbane QLD 4001 Phone: Web: Manager Licensing and Compliance GPO Box 530 Phone: (08) Fax: (08) mvr@nt.gov.au Web: Senior Manager Transport Policy Driver Licensing PO Box 673 Fortitude Valley QLD 4006 Phone: (07) Fax: (07) South Department of Planning, Transport and Infrastructure GPO Box 1533 Phone: Fax: (08) DPTI.enquiriesadministrator@sa.gov.au Web: Manager Driver Licensing Department of Planning, Transport and Infrastructure Locked Bag 700 GPO Phone: (08) Fax: (08) Tasmania Department of Infrastructure, Energy and Resources Phone: Fax: (03) dier@dier.tas.gov.au Web: Medical Review Officer Registration and Licensing Branch Department of Infrastructure, Energy and Resources Phone: (03) Victoria VicRoads Medical Review PO Box 2504 Kew VIC 3101 Phone: medicalreview@roads.vic.gov.au Web: VicRoads Medical Review PO Box 2504 Kew VIC 3101 Phone: (03) medicalreview@roads.vic.gov.au Web: 149

3 Western GENERAL CONTACT DETAILS DRIVER LICENSING AUTHORITY GPO Box R1290 Perth WA 6844 Phone: Fax: (08) Web: HEALTH PROFESSIONAL ENQUIRIES Team Leader Driver Assessment Section GPO Box R1290 Perth WA 6844 Phone: (08) Fax: (08) Web: HEAVY VEHICLE DRIVER LICENSING ENQUIRIES PUBLIC PASSENGER VEHICLE DANGEROUS GOODS VEHICLE n Capital Dangerous Substances Team Office of Regulatory Services ACT WorkCover GPO Box 158 Canberra ACT 2601 Phone: (02) Fax: (02) New South Wales Northern Transport NSW Licensing and Accreditation Locked Bag 5085 Parramatta NSW 2124 Phone: (02) Fax: (02) Department of Conservation and Environment PO Box A290 Sydney South NSW 1232 Phone: or (02) Fax: (02) NT WorkSafe Department of Justice GPO Box 1722 Phone: Fax: (08) Queensland Industry and Operator Authorisation Team and Main Roads PO Box 673 Fortitude Valley QLD 4006 Phone: (07) Fax: (07) South Accreditation and Licensing Centre Department of Planning, Transport and Infrastructure PO Box 9 Marleston BC SA 5033 Phone: (08) Fax (08) Dangerous Substances Team SafeWork SA Department for Administrative and Information Services GPO Box 465 Phone: (08) Fax: (08)

4 HEAVY VEHICLE DRIVER LICENSING ENQUIRIES PUBLIC PASSENGER VEHICLE DANGEROUS GOODS VEHICLE Tasmania Driver Licensing Unit Department of Infrastructure Energy and Resources Phone: (03) Workplace Standards Tasmania PO Box 56 Rosny Park TAS 7018 Phone: Victoria Victorian Taxi Directorate Level Collins Street Melbourne VIC 3000 Phone: Fax (03) WorkSafe Victoria Licensing Branch GPO Box 4293 Melbourne VIC 3001 Phone: (press 4) Fax: Western Department of Consumer and Employment Protection, Resources and Safety Division 100 Plain Street East Perth WA 6004 Phone: (08) Fax: (08)

5 Appendix 9: Specialist driver assessors CONTACTS FOR OCCUPATIONAL THERAPIST SPECIALIST DRIVER ASSESSORS (as at JULY 2011) REGION ORGANISATION CONTACT n Capital Driver Assessment and Rehabilitation Program (Canberra Hospital) (02) New South Wales OT AUSTRALIA New South Wales (02) Northern OT AUSTRALIA Northern Queensland OT AUSTRALIA Queensland (07) South OT AUSTRALIA South (08) Tasmania OT AUSTRALIA Tasmania (03) Victoria VicRoads Medical Review (03) Western OT Western (08) Independent Living Centre of WA (Inc) Help line OT AUSTRALIA has a listing of occupational therapists qualified in driver assessment. Visit the OT AUSTRALIA website ( 152