With diabetes rates for truckers running 50 percent higher than the national average, industry and health advocacy groups are working to raise awareness about how drivers can manage the disease and ensure a high level of public safety.
About 15 percent – or 500,000 truckers in the United States – have diabetes.
What is more, only 100,000 of those drivers check their glucose levels, said Kay Pfeiffer, a vice president at diabetes management company TrueLifeCare,
“It’s a crash waiting to happen,” said Pfeiffer, a frequent speaker at trucking shows.
Diabetes is a disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose-surge in the blood and urine. There are two types of diabetes – Type I and Type II. The majority of people with the disease have Type II, in which the body produces insulin, but is unable to use it effectively.
With diabetes comes numerous health risks, ranging from numbness and tingling in extremities to blindness and death. Every six seconds someone dies of diabetes; every seven seconds someone has a limb amputated, according to the Centers for Disease Control and Prevention (CDC).
Truckers’ lifestyles put them at higher risk for Type II diabetes, health experts say. Driving a truck is a sedentary profession, and many drivers eat mostly fast food on the road. Many truckers are overweight, another risk factor.
There is no cure for diabetes, but it can be managed through lifestyle changes and medication.
“We tell folks, eat well, exercise, all those good things,” said Malorie Marrs, executive director of the Arkansas and Oklahoma chapters of the American Diabetes Association (ADA). “If you get a 30-minute break, take a walk.”
Arkansas is one of the “Diabetes Belt” states, a string of 15 states, mostly in the South, with a higher incidence of diabetes. Nearly 12 percent of people who live in this region have diabetes, compared with 8.5 percent of people in the rest of the United States, according to the CDC.
On March 9 the Arkansas chapter is hosting its annual “Kiss a Pig” fundraiser. Before the advent of biotechnology, insulin was harvested from pigs, “so we kiss the pig for being lifesaving,” Marrs said.
Western Express, a trucking company based in Nashville, Tennessee (another Diabetes Belt state), is one of the fundraiser’s corporate sponsors. Western Express declined comment for this article. Multiple trucking companies and state trucking associations declined to comment or did not return requests for comment.
On this issue industry has to walk a fine line between ensuring drivers with diabetes are safe to drive and not discriminating against drivers with the condition.
“There are a lot of drivers that should not be driving,” Pfeiffer said. “They like to eat a lot of sugar; their hands and feet get numb. That’s very dangerous.”
Healthcare costs are part of the problem, Pfeiffer said, as insulin monitors and medication are expensive.
Carriers won a hard-fought battle last fall, when the Federal Motor Carrier Safety Administration (FMSCA) revised federal regulations permitting individuals with a stable insulin regimen and properly controlled insulin-treated diabetes to be qualified to operate commercial motor vehicles.
Since 2003, drivers with insulin-treated diabetes have had to apply for an exemption through FMCSA to be allowed to drive interstate.
The new rule allows certified medical examiners to grant truckers with insulin-treated diabetes a Medical Examiner’s Certificate that’s good for one year.
“FMCSA issued thousands of waivers to allow drivers who have insulin-treated diabetes to operate commercial vehicles because they were not seen to be a safety risk and very recently, it removed insulin-treated diabetes from its list of disqualifying medical conditions,” said Sean McNally, a spokesperson for the American Trucking Associations, in an email. “This suggests FMCSA believes simply having diabetes is not a significant safety risk.”
That said, the ATA encourages drivers to “make good individual decisions while on the road about diet and exercise,” McNally wrote. “In addition, we encourage not just drivers, but everyone in the trucking industry to see their doctor regularly for screenings for diabetes and other illnesses.”
Pills alone won’t solve the lifestyle problems responsible for the disease, health experts noted. “But managing diabetes through lifestyle takes a lot of work; more than the typical person wants to put in,” said Stefanie Cullingford, a Kaiser Permanente dietician who works with truckers afflicted with the disease.
Many of her truck driver clients have adapted by bringing along coolers stocked with healthy food, drinking plenty of water, getting a good night’s sleep and reducing stress.
Motivated individuals can make it work, Cullingford said. “Truck drivers come to me saying: ‘I’m going to lose my job. What do I have to do?’ We can help them so they don’t lose their job and keep driving.”