Carbohydrate metabolism disturbances among public transport drivers--the need for regulations in Poland.

INTRODUCTION The discussion on the relationship between diabetes and driving has continued in recent years all over the world. The issue of diabetes, its treatment models, the risk of hypoglycaemia and license to drive are receiving considerable attention. Driving ability is controlled by specific regulations. Polish legislation does not provide standard procedures for dealing with the question of diabetic drivers and driver candidates. The aim of study was to draw attention to some problems that may emerge when attempting to certify medical fitness of drivers or driver candidate to drive public service vehicles. MATERIALS AND METHODS Data were obtained from standardised prophylactic examination forms of public transport drivers employed in a small company between 2001 and 2007. Fasting capillary blood was collected to be analysed with a blood glucose meter. RESULTS Diabetes and its diagnosing during obligatory preemployment or periodic medical examinations constitutes a serious problem. Abnormal fasting glucose levels were noted in 23 drivers (21.7%). DISCUSSION Our study shows that the occupational physician must take into account the possibility of glucose metabolism disturbances. The results demonstrate that an unified approach to diagnosing of diabetes mellitus during such medical examinations is not available currently in Poland. CONCLUSIONS It is necessary to develop standard procedures to be used by occupational physicians for diagnosis diabetes mellitus and intermediate hyperglycaemia. Fasting capillary blood glucose measurement with a blood glucose meter may be used for screening, because it is easier, less expensive and less invasive than venous blood tests. Screening tests must be followed by oral glucose tolerance test using standard criteria in order to make the diagnosis. Frequency of periodic medical assessments in case of diagnosed diabetes mellitus or any intermediate hyperglycaemia must be determined. Specific situations must be identified when the consultation of diabetes specialist is mandatory with respect to therapy, risk of hypoglycaemia and hypoglycaemia awareness.