One in Five Belgian Diabetics Lack Adapted Driving Licence

Nearly one in five people with diabetes in Belgium are driving without the legally required adapted driving licence, according to a new survey by road safety institute Vias, the Diabetes Liga and the Association du Diabete. The oversight could expose thousands of drivers to fines or complications with their insurance coverage.

The survey of 1,136 people with diabetes who hold a driving licence found that 22 percent do not have an adapted licence, despite it being mandatory under Belgian law for every person diagnosed with diabetes, regardless of type or treatment. As VRT NWS reported, approximately one million Belgians live with diabetes.

A Legal Obligation Often Overlooked

Under Belgian law, anyone diagnosed with diabetes must apply for an adapted driving licence within four working days of diagnosis. The licence must be renewed every five years after a medical examination for private drivers, and every three years for professional drivers. The requirement applies to all types of diabetes except gestational diabetes, as Gezondheid.be explains.

Despite this clear legal framework, the survey reveals significant gaps in awareness. Eighteen percent of respondents believe an adapted licence is not necessary for people with diabetes, while 27 percent think it only applies to certain types of diabetes, from a certain age, or only when complications arise. Even more concerning, 43 percent believe there are no consequences for driving without the adapted licence.

“There is thus a big gap between what the law says and what people with diabetes know or do in practice,” said Stef Willems, spokesperson for Vias, in the official press release. “Driving without an adapted driving licence can have consequences for insurance. Possibly it won’t cover you or you’ll get a fine.”

Why the Adapted Licence Matters

Diabetes can significantly affect driving ability. Hypoglycemia—dangerously low blood sugar—can cause confusion, tremors, sweating, loss of concentration, double vision, or even loss of consciousness. Hyperglycemia, or high blood sugar, can temporarily blur vision and cause drowsiness. Long-term complications such as eye damage, nerve damage, and cardiovascular problems can also impair driving ability.

Kris De Vuyst, a patient expert at the Diabetes Liga who lives with the condition, described the risks firsthand: “When I have a ‘hypo’, I get a sweaty feeling and my hands start to tremble. You suffer from loss of concentration, and you don’t want that while driving.”

De Vuyst acknowledged that the requirement is easily overlooked. “Some patients are not well informed, because sometimes GPs don’t think of it themselves,” he told VRT NWS. “Patients may also not realize it could be important. But that’s also logical, because so much comes with a diagnosis.”

Insurance Implications

Driving without an adapted licence means the driver does not legally hold a valid driving licence. This can lead to fines and, critically, complications with insurance coverage in the event of an accident—even one unrelated to diabetes.

The survey found that only 40 percent of respondents correctly know they may not be insured in case of an accident if not in compliance. Seventeen percent believe they are never insured at all.

Insurance companies cannot refuse to insure a person with diabetes who holds a valid fitness-to-drive certificate, nor charge a higher premium. However, drivers must inform their insurer about their adapted licence with limited validity—failure to do so can invalidate the policy, as UZ Leuven notes.

Precautions on the Road

The survey also examined safety behaviours while driving. Only 19 percent of respondents are concerned about hypo- or hyperglycemia while driving, while 64 percent are rarely or never concerned. One in three always carries fast-acting sugars while driving, 18 percent regularly check their blood sugar levels, and 25 percent regularly take breaks during long journeys.

Aurelie Lampaert, content director at the Diabetes Liga, struck a cautiously optimistic tone: “Driving with diabetes is safer than ever today thanks to better treatments and technology. But technology does not replace the responsibility of the driver. It is hopeful that the vast majority of people with diabetes already take precautions when they hit the road. Yet these results show that continued sensitization is needed.”

A Campaign for Greater Awareness

The three organizations are launching a sensitization campaign targeting people with diabetes and healthcare providers. The initiative aims to close the knowledge gap and ensure patients understand their legal obligations. A digital information session on “Driving with Diabetes” is planned for November 24 in Dutch and October 12 in French.

For those recently diagnosed or unsure about their status, the process is straightforward: obtain a medical fitness-to-drive certificate from a GP or endocrinologist, then present it at the municipal administration. The adapted licence is in principle free, though municipalities may charge administrative fees for first-time applications or replacements.

As De Vuyst advises: “Get good guidance from specialists and your GP. They can give many tips. When you go into traffic with the car, first check your values and correct if necessary. Don’t take risks.”