Truck Driver Diabetes: How to Manage Diabetes on the Road

Most drivers know about the scary diseases out there that can quickly end a career – heart disease, stroke, etc. But what about the more quiet diseases, like diabetes? Type 2 diabetes doesn’t exactly strike suddenly – it’s something that can creep up over time until one day it makes itself known and suddenly you’re unable to renew your DOT medical card after being put on insulin. Are you at risk for truck driver type 2 diabetes?

5 Major Risk Factors for Truck Driver Diabetes


Extra body weight can have a direct impact on your risk of developing diabetes. Ninety percent of people with Type 2 diabetes are overweight. Carrying excess weight puts pressure on the body’s ability to control blood sugar using insulin. It causes insulin resistance which can eventually lead to diabetes. Obese adults are 7 times more likely to develop diabetes than adults of a healthy weight.

Technically speaking, "obese" is defined as:

Having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat, and/or body water.

A person is obese when excess body fat accumulates to the point where adverse health risks can begin to occur. Many truck drivers report gaining upwards of 40 pounds after starting life on the road, making obesity a very real concern on the road and putting drivers at risk of developing type 2 diabetes.

Poor Eating Habits

What does your diet look like? Do you eat lots of whole grains, fruits, vegetables, and lean proteins, or are you more prone to stop at the nearest Flying J for a cheeseburger value meal? Diets that are heavy in refined, calorie-dense foods will increase the risk of diabetes.

We all know that the typical truck driver diet isn't exactly one filled with colorful fruits and veggies. The reality is that for many drivers, it's easy to lose track of eating habits without a sturdy health plan.

Physical Inactivity

What about your workout plan? Do you make time in your daily schedule to stop for 30 minutes and go for a walk or do some strength training? Lean muscle mass protects our bodies against insulin resistance and type 2 diabetes.

I know it seems almost impossible to get exercise on the road. "Amanda, I drive 11 hours a day and I'm sitting for 14! There's no time!"

I know, I know. I've heard it all before. That's why it's important to take advantage of those mandatory breaks required by FMCSA. You have 30 minutes each day where you're legally not allowed to be driving. This is as good a time as any to get some exercise in! All you need is 15-30 minutes a day. Get it done, whether it be before/after a shift, during a 30 minute break, or while there's time to kill waiting at a shipper or receiver.


"There’s a tendency in our society to assume that type 2 diabetes is a disease of biblical sin. The sins of sloth and gluttony. The truth is, it’s a very genetic disease. There’s a strong genetic component to it," says William Polonsky, President of the Behavioral Diabetes Institute.

Listen: Interview with William Polonsky

Do you have family members with diabetes? If so, a driver is automatically at risk of developing type 2 diabetes. However, it can be prevented or delayed with a good diet and exercise plan.

Smoking Habits

Are you a smoker? Smokers are 30-40% more likely to develop type 2 diabetes than their non-smoking counterparts. 67 percent of truck drivers smoke. Imagine 67 out of 100 people being diagnosed with type 2 diabetes due to their smoking habits. Pretty eye opening.

Did you answer yes to any of these questions? If so, there’s good news! Most of these, with the exception of genetics, are controllable risks, which means that as long as habits are changed, drivers can prevent and even treat diabetes and as a result, keep driving and keep their medical card. We’ll get into treating diabetes in a future post.

Why is diabetes a big deal for truckers?

Many people wrongly believe that all diabetes means is that a person can’t eat sweets. Not quite. Diabetes is when your pancreas can’t produce enough insulin to keep up and causes a person’s blood sugar to rise. It’s important to take diabetes seriously and treat it as such because long-term complications can include heart attack, stroke, eye problems, nerve damage, kidney problems, gum disease, and amputation. Diabetes causes more deaths each year than breast cancer and AIDS combined and 2/3 of people with the disease die from heart attack or stroke. So yeah, it’s a pretty big deal.

But aside from the obvious health-related risks and complications that come with it, diabetes can actually end a trucker's driving career if the time isn't taken to get it under control. Currently, the FMCSA does not allow type 2 diabetics who are on injected insulin to drive a tractor trailer unless they’ve applied for and been granted a waiver. However, the process of actually getting a waiver is long and arduous, so the best plan is to do it the old fashioned way to preventing or treating diabetes to ensure you can continue a trucking career.

How do I know if I have diabetes?

So we know why diabetes is a big deal and how it can end a driver's career if they let it. Naturally, the next logical question is, "How do I get tested for diabetes?"

Many times, type 2 diabetes is diagnosed as a result of some other health condition. A driver will visit the doctor for something seemingly unrelated, get some tests run, and find out they have type 2 diabetes. 

Polonsky says, "One test, a simple blood test done at your doctor’s office (the A1C), measures your average blood sugar over the past 2-3 months and that’s one of the best measures of telling us whether you’re at high risk of running into the scary long term complications of diabetes." 

For those who would like to get tested, there are two tests used:  a fasting plasma glucose test and a random glucose test. These are blood tests either taken in the morning on an empty stomach (fasting glucose), or during the day without fasting (random glucose). Glucose levels of above 126 mg/dl for fasting glucose and above 200 mg/dl for random glucose may suggest diabetes.

Driving with Diabetes

After receiving a type 2 diabetes diagnosis, the first question most truckers ask is, "Will I still be able to drive for a living?"

The answer to this is a not-so-simple, "It depends."

As it stands, FMCSA allows diabetics who aren't on insulin to drive. If diabetes is controlled by oral medications and/or diet and exercise, it should not disqualify a driver.

However, diabetics who take insulin may still apply for a waiver that allows them to drive -- the process is just long and frankly, difficult. It requires being evaluated by an endocrinologist and ophthalmologist and providing any information required to the FMCSA.

Managing Truck Driver Diabetes

"If you manage diabetes and manage your diet, if you can do things to control your weight and watch what you eat, we may still develop diabetes as we get older just because that’s the natural process. People weren’t designed to live as long as we do now. But if you go into it, manage it, and are aware of being at risk, you can still exist and do whatever you want without being impacted too much by the condition," says Richard Brook, MS, MBA and lead researcher of United States comparative costs and absenteeism of diabetic opthalmic conditions.

LISTEN:  Interview with Richard Brook:

If you have Type 2 diabetes but you're not on insulin, you can keep driving, as long as you keep your diabetes under control on the road. There are a few ways in which to do this...


Following a healthy diet is probably the most important thing to do when managing type 2 diabetes. A healthy diet can help keep your blood glucose at acceptable levels and in a safe range. A diabetic diet includes foods rich in healthy carbs (fruits, veggies, whole grains, and legumes), fiber, heart healthy fish, and good fats. Avoid foods high in saturated and trans fats, cholesterol, and sodium. We'll talk at length about the best diet for diabetics in a future post.


Like with most health problems and conditions, exercise is a great way to both prevent and treat illness. While your options for exercise may be somewhat limited on the road, there are always things to do. Get out and walk at the truck stop or do some weight exercises in the cab of your truck. We'll cover more on exercise for diabetics in a future post.


"Given most of our lifestyles, it’s extraordinarily difficult to be successful with type 2 diabetes without taking some sort of medication," Polonsky says. Combined with a healthy diet and exercise plan, prescription medications can help drivers keep their diabetes under control. There are several different diabetes drugs that work in different ways.

Diabetic medications are allowed by DOT so long as they're oral -- insulin is not permitted by DOT.

Any diabetes medications should be used only under the care and supervision of a qualified health provider. Talk with your doctor about whether you have a need for medication or not.

"If you don't manage diabetes, everything can just kind of snowball into bigger problems, so it's important to stay on top of everything," says Scott Evans, OTR truck driver and type 2 diabetic.

Wrapping Up

While type 2 truck driver diabetes is not a death sentence, it's a good idea to get it treated and controlled as soon as possible. With the right treatment and management, it's very possible for drivers to keep their career as an over-the-road truck driver. In fact, plenty of drivers do it every year. The important things to remember are 1) watch your diet; 2) get some physical activity; and 3) don't slack on your medication if your doctor prescribes it!

Get more information on a diabetic truck driver diet.

Get more info on exercising with truck driver diabetes.

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