Diabetes affects nearly 4 million people in France. Most drive without incident for decades. Yet the 2026 regulation sets clear rules, especially for insulin-treated patients. Here is what the 28 March 2022 decree still in force says, and how to apply it concretely without panic.
The legal framework in 2026
The 28 March 2022 decree
The decree listing medical conditions incompatible with the licence ranks diabetes among conditions that may cause temporary incompatibility. It clearly separates patients on simple oral treatment, hardly concerned, from patients on insulin therapy, subject to a mandatory medical review. The logic is simple: only the treatment, not the condition itself, triggers the duty to declare.
Type 1 and type 2: same rule, different doses
Type 1, often appearing young and requiring insulin from the start, always falls under mandatory review. Type 2, appearing later, only requires the review if treatment moves to insulin or includes certain drugs with hypoglycaemia risk. A type 2 patient on metformin alone is not required to declare. It is the introduction of insulin or sulphonylureas that triggers the process.
The mandatory medical review
Frequency and validity
For the light group (B, A licences), the review takes place every 5 years as a rule. It can be shortened to 1 year in cases of complex insulin therapy, recent severe low blood sugar episodes or progressing complications. For the heavy group (trucks, buses, taxi, VTC), the frequency is yearly with stricter criteria. The licence is no longer issued for life: validity depends on each review.
Cost and place
The review takes place with a prefecture-approved doctor, separate from the treating diabetologist. The fee is unregulated, usually between 30 and 50 euros, not reimbursed by health insurance. Bring the latest self-monitoring log, latest HbA1c, treatment prescription and a recent report from the diabetologist. The more complete the file, the faster and more favourable the opinion.
Low blood sugar at the wheel
Recognising early signs
Low blood sugar is the major issue when driving with diabetes. Sweating, shaking, blurry vision, slowness, confusion: these signs must trigger an immediate stop. Pull over, switch off, take 15 grams of fast sugar and wait 15 minutes before restarting. Driving in hypo means risking a serious crash for which liability will fall fully on you. The insurer can deny cover.
Best practices before each trip
Measure blood sugar before driving if you are on insulin. If it is below 1 g/L, eat before leaving. Always keep fast sugar within reach in the glove box or console. On long trips, take a break every 2 hours to check and snack. Continuous glucose monitors, increasingly reimbursed in 2026, are a precious help to anticipate drops.
Heavy group and professional driving
Stricter rules
If you drive a truck, bus, taxi or VTC, the requirements are higher. Any severe hypo (needing third-party help) forces immediate stop of professional driving for at least 12 months, sometimes longer. The review is yearly without exception. A full diabetes file and a continuous glucose monitor are nearly essential to keep a favourable opinion. Liability is heavier and the handover with the employer must be clear.
Career change or job adjustment
In case of a definitive unfavourable opinion on the heavy group, the occupational doctor and the industry branch can support a career change. The B licence is often kept, allowing some replacement activities. Occupational medicine has possible adjustments: hours, short routes, extra breaks. Do not endure the decision in silence, talk to your contact.
Practical recap: do you have to declare
Three questions to ask
First: am I on insulin or on a drug with hypo risk? If yes, the review with the approved doctor is mandatory. Second: do I drive in a professional category? If yes, the rhythm is annual. Third: have I had a severe hypo in the last 12 months? If yes, immediate declaration to the approved doctor, likely suspension and reassessment. Answering these three questions honestly avoids many later troubles.
DevisPermis expert opinion
Classic trap: not declaring a switch to insulin thinking nothing changes. In case of a crash, the insurer investigates and can deny cover. Our advice: even if the step feels heavy, see the approved doctor as soon as treatment changes. It is just one consultation and secures everything else. Another tip: get a continuous glucose monitor if your diabetologist offers it. It is the most reliable tool for calm driving. Finally, never drive on an empty stomach with injected insulin, this is the most common mistake leading to a crash.
Find your driving school with DevisPermis.fr
DevisPermis.fr finds the right driving school for your situation, whether you are preparing your first licence or returning to driving after a treatment change. For diabetic patients, some partner schools are used to advising on glucose management during lessons. Fill in the form in two minutes: we select three schools, call you back within 48 hours, and you receive comparative quotes with no commitment. Driving with well-managed diabetes is perfectly safe, provided you are well trained.
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Frequently asked
Your questions on this topic
Is diabetes a contraindication to the B licence?
No, diabetes is not a contraindication to the B licence in France. The decree of 28 March 2022 sets the conditions: balanced diabetes, no recent severe hypoglycaemia (less than 12 months for the light group). A medical check by an approved doctor is mandatory every 5 years for type 1 insulin-treated diabetics. Type 2 diabetes without insulin does not require a check.
How often is the medical check for insulin-dependent diabetes?
For the B licence with insulin-treated diabetes, the check by an approved doctor is mandatory every 5 years (decree 28 March 2022). For heavy licences (C, D), frequency drops to every 3 years. Cost: 36 euros (fixed rate), not reimbursed by Social Security but sometimes covered by mutual insurance. Application via Cerfa form 14880*02.
How to prevent hypoglycaemia while driving?
Before each trip: capillary blood glucose check (objective 1 g/L minimum), break every 2 hours for re-sugaring if needed. Always keep 3 fast sugars and a snack (cereal bar) within reach. In case of symptoms (tremor, sweat, blurred vision), immediate stop on the emergency lane, re-sugaring and wait 15 minutes before resuming. Continuous blood glucose monitor strongly recommended.
Should you declare your diabetes to car insurance?
Yes, balanced diabetes must be declared to the insurer if you are subject to the mandatory medical check (decree 28 March 2022). Omission can entail contract nullity. Most insurers do not increase the premium if the medical check is up to date. In case of severe hypoglycaemia having caused an accident without up-to-date check, refusal of compensation is almost systematic.
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