Diabetes mellitus und Straßenverkehr – ein Positionspapier der Österreichischen Diabetesgesellschaft (Update 2026)

Public safety (prevention of accidents) is the primary objective in assessing fitness to drive a motor vehicle; however, the general access to mobility should not be restricted if there is no particular risk to public safety. For people with diabetes mellitus, the Driving Licence Legislation (FSG) and the Driving Licence Legislation Health Act (FSG-GV) regulate important aspects of driving safety in connection with acute and chronic complications of the disease. Critical complications that may be relevant to road safety include severe hypoglycemia, pronounced hyperglycemia and hypoglycemia perception disorder as well as severe retinopathy and neuropathy, end-stage renal disease and certain cardiovascular manifestations. If there is a suspicion of the presence of one of these complications, a detailed evaluation is required.In addition, individual antihyperglycemic medications should be checked for existing potential for hypoglycemia. Sulfonylureas, glinides and insulin belong to this group and are therefore automatically associated with the requirement of a 5-year limitation of the driver's license. Other antihyperglycemic drugs without a potential for hypoglycemia, such as metformin, dipeptidyl-peptidase-4 (DPP-4) inhibitors (gliptins), sodium-glucose cotransporter‑2 (SGLT-2) inhibitors (gliflozins), glitazones and glukagon-like peptide‑1 (GLP-1) receptor agonists as well as dual GLP-1/glucose-dependent insulinotropic peptide (GIP) receptor agonists are not associated with such a time limitation. The relevant laws which regulate driving safety give room for interpretation, so that specific topics on driving safety for people with diabetes mellitus were subsequently elaborated from a medical specialist and traffic-relevant point of view. This position paper is intended to support people involved in this challenging matter.