Appendix 1: Questionnaire Please remember that all information given in this questionnaire is kept confidential Patient number: Date

of interview: _____ _____

Patient Demographics 1) Sex 2) Age 3) Occupation unemployed Male Female (please circle) ___ years manual, semi-skilled, skilled, professional, retired, specify _________________

Diabetes 4) Date of diagnosis of diabetes ______ 5) Type of diabetes (to be completed by the researcher) Type 1 ___ Type 2 ___ 6) Date of commencing insulin at diagnosis ___ other date (type 2) ___ 7) HbA1c at this/last clinic visit ___ % Treatment Regimen 8) Time of day Before breakfast before lunch before evening meal bedtime Oral therapy (tablets)? Specify ______________________ Home Blood Glucose Testing 9) Do you measure your blood glucose? (tick usually applies) No, never ___ Only if I think it is too high or too low Less than once a week At least once a week At least three times a week At least once a day Three or more times a day description ___ ___ ___ ___ ___ ___ that

Insulin type

Dose (units)

Hypoglycaemic History 10) Have you ever experienced hypoglycaemia glucose)? Yes __ No __

(low

blood

11) If YES, approximately how often do you have a mild hypo? A mild hypo is one that can be treated by yourself. [Question should assess patients subjective view of hypoglycaemic onset but quote 4 mmol/l if asked for a blood glucose level] Less than 1 per year ___ Less than 1 per month (1-3 per year) At least 1 per month ___ 2 or more per month ___ At least 1 per week ___ 3 or more per week ___ ___

12) To what level does your blood glucose fall before you have symptoms of mild hypoglycaemia? Doesnt measure hypoglycaemia above 4.0 mmol/l mmol/l __ 3.0-2.6 mmol/l __ blood sugar during __ __ 4.0-3.6 mmol/l episodes __ 3.5-3.1 of

2.5-2.0 mmol/l __ below 2.0 mmol/l __

13) If yes to Q11, how many severe hypos have you had in the last year (a severe hypo is one in which you have felt that you needed assistance from another person) None:___ One: ___ Two-five: ___ more than 5: ___ 14) 15) Do you know when a hypo is starting? always 1 2 3 4 5 (please circle) 6 7 never

At what time of day do you usually have hypos? (please tick) Before breakfast __ Before lunch __ Before evening meal __ At bed-time __ Through the night __ Any time __ Do you check your blood glucose while experiencing a hypo? (please circle) always 1 2 3 4 5 6 7 never

16)

Driving 17) Do you have a current driving licence? (please tick) Provisional __ Ordinary __ C1 __ 18) How long have you held a driving licence? Less than a year __ 1-5 years __ 5+ years __

19)

Is there a period restriction on your licence? Yes __ No __ If yes: 1 year __ 2 years __ 3 years __ How many miles do you usually drive in a year? Less than 5,000 __ 5,000-9,999 ___ 10,000-20,000 __ More than 20,000 __ Do you travel to work by car? Yes __ No __ Retired __ Unemployed __ If YES, Every day __ At least twice a week __ Once a week __ Less than once a week __

20)

21)

22) Do you have to drive as part of your job, other than commuting to and from work? (please choose the statement that most closely matches your usual driving habits) Yes __ No __ Retired __ Unemployed __ If YES, Everyday __ At least twice a week __ Once a week __ Less than once a week __ 23) Is driving essential for your job? __ N/A __ Yes __ No

Blood Glucose Monitoring While Driving 24) Do you carry your blood glucose testing kit with you while driving? (please circle) Always Only on long journeys (>2 hours) Sometimes Never 25) Do you test your blood glucose level before driving? (please tick statement that most closely applies to your testing habits No, never ___ Yes, but only if I think it may be too high or too low ___ Yes, but less than 1 in 10 journeys ___ Yes, about 1 journey in 5 ___ Yes, at least every other journey (1 in 2) ___ Yes, every journey ___ 26) If you were about to set off on a car journey lasting more than two hours would you test your blood glucose before you drive? No, never ___ Yes, but only if I think it might be too high or too low ___ Yes, but less than 1 in 10 journeys ___ Yes, about 1 journey in 5 ___ Yes, at least every other journey ___ Yes, for every journey ___

27) If you were about to set off on a car journey lasting between half an hour and two hours would you test your blood glucose before you drive? No, never ___ Yes, but only if I think I might be too high or too low ___ Yes, but less than 1 in 10 journeys ___ Yes, about 1 journey in 5 ___ Yes, at least every other journey ___ Yes, for every journey ___ 28) If you were about to set out on a car journey lasting less than half an hour would you test your blood glucose before you drive? No, never ___ Yes, but only if I think it might be too high or too low ___ Yes, but less than 1 in 10 journeys ___ Yes, about 1 journey in 5 ___ Yes, at least every other journey ___ Yes, for every journey ___ 29) When driving do you ever test your blood glucose level during a journey? Always Only on long journeys (>2 hours) Sometimes Never 30) If yes to Q29, for how long would you drive before testing? ___ hrs or ____ miles 31) If yes to Q29, which statement is most applicable? always test 1 2 3 4 5 6 7 test never

Driving and hypoglycaemia 32) Have you ever experienced hypoglycaemia while driving? Yes __ No __ 33) Have you experienced hypoglycaemia in the last year? Yes __ No __

34) How many mild hypos have you had in the last year while driving? (A mild hypo is one that could be treated by yourself without medical assistance) 0 __ 1-2 __ 3-5 __ more than 5 __ 35) How many severe hypos have you had in the last year while driving, a severe hypo is when assistance is required from another person? 0 __ 1-2 __ 3-5 __ more than 5 __

36) Has an episode of hypoglycaemia while driving resulted in an accident? (Includes any accident when they were hypoglycaemic whether they thought they were responsible or not) No hypos while driving __ Accident in the last year __ Accident at any time __ Episode(s) did not result in an accident __ 37) If YES to question 36, did the accident result in: Damage to vehicle __ Damage to person(s) __ (other than minor cuts & bruises) 38) Did you measure your blood glucose when you had a mild hypo? No hypos while driving __ Always __ Sometimes __ Never __ 39) Did you measure your blood glucose when you had a severe hypo? No hypos while driving __ Always __ Sometimes __ Never __ Action taken if hypoglycaemia is suspected while driving 40) Do you carry some type of carbohydrate in the car for the treatment of a hypo? Always Only on long journeys (>2 hours) Sometimes Never 41) If yes, what type of carbohydrate? (please tick) Glucose tablets __ Biscuits __ Chocolate bar __ Confectionery (sweets) __ Soft drink or Energy drink __ Other (please specify) ____________

42) If you thought you were becoming hypoglycaemic while driving would you? Carry on driving __ Continue driving but with increased care __ Stop driving, eat some food or have a sugary drink, then carry on driving __ Stop driving, eat some food or have a glucose drink and then rest for at least half an hour before driving again __ 43) Assuming you are carrying your blood glucose testing kit, would you measure your blood glucose after treating the hypo? (please circle) Always Only if severe Sometimes Never

44) If yes to Q43, how long after treating the hypo would you wait before measuring blood glucose? (please circle) Wouldnt measure Immediately 5-10 mins 11-20 mins 21-30 mins 31-40 mins >40 mins 45) How long would you wait after treating the hypo before starting driving again? (please circle) Wouldnt stop Immediately 5-10 mins 11-20 mins 21-30 mins 31-40 mins >40 mins 46) Do you reduce your insulin dose to allow for the increased energy required for driving, especially over a long distance? (please tick) Always Only if on long journeys Sometimes Never 47) If yes, by how much? 5% __ 10% __ 20% __ >20% __

Knowledge 48) Below which blood glucose level would you consider it unsafe to drive? ___ mmol/l 49) Have you ever received detailed advice about driving and diabetes? Yes __ No __ 50) If yes, from what source? (please tick all that apply) Diabetic clinic doctor ___ Family/Friends ___ Diabetic clinic nurse/dietician ___ Diabetes literature ___ GP ___ Newspaper/magazine ___ GP practice nurse ___ Internet ___ Other medical professional ___ DVLA ___ 51) Are you required by law to inform the DVLA that you have insulin-treated diabetes? Yes __ No __ Not sure __ 52) Have you informed the DVLA that you have insulin-treated diabetes? Yes__ No __ 53) Are you required by law to inform you motor insurance company that you have insulin-treated diabetes? Yes __ No __ Not sure __

54) Have you informed your motor insurance company that you have insulin-treated diabetes? Yes__ No __ If no to Q49, ask where they received the advice concerning the answer to Q51-54 [because several patients reported that they been given no advice, but did in fact know the correct answers, and subsequently agreed that they had been informed by the clinic] 55) From what source? (please tick all that apply) Diabetic clinic doctor ___ Family/Friends ___ Diabetic clinic nurse/dietician ___ Diabetes literature ___ GP ___ Newspaper/magazine ___ GP practice nurse ___ Internet Other medical professional ___ DVLA Unknown source ___

___ ___