Diabetes has become a serious global problem and the number of people with diabetes is increasing year by year not only in developed countries but also in developing countries. 124 million people had diabetes worldwide in 1997 and the World Health Organization estimates that it will rise to 300 million by 2025. With the development of our economy and the improvement of people’s living standards, diabetes, formerly a “disease of wealth”, has become a common disease among the general public. At the same time, the popularity of cars has made many sugar lovers have or will have cars. A survey in developed countries in the West showed that about 1/3 of traffic accidents happen to diabetic drivers! When I was in the eye clinic, I also often contacted sugar patients complaining of blurred vision and difficulty in driving, and some of them even had serious traffic accidents. So, can diabetic eye disease patients drive or not? Or can they drive safely? To answer this question, we first need to briefly understand diabetes. Diabetes is generally divided into type I and type II diabetes. Type I diabetes mainly develops in young people and is strongly insulin dependent. Type II diabetes mainly develops in middle-aged and older people, and is closely related to obesity and dietary habits, and most sugar lovers belong to this type. Diabetes is a systemic chronic disease, with a duration of more than 5 years. Even if the blood glucose is well controlled, abnormalities of the nervous system, cardiovascular system, renal system and eyes may occur, among which eye lesions leading to low vision are the greatest threat to driving safety. Diabetic eye lesions mainly include keratopathy, ocular muscle paralysis, glaucoma, cataract, retinopathy and other complications. The most significant of these are diabetic cataracts and diabetic retinopathy, the consequences of which often lead to vision loss, and drivers can be involved in car accidents due to poor vision. Cataracts that occur in diabetic patients are closely related to fluctuations in blood sugar. If blood sugar rises, the lens will absorb water and swell within a few minutes, and the patient can feel blurred vision. If the rise in blood sugar happens during driving, the sudden blurred vision is very dangerous. Therefore, sugar lovers with high blood sugar fluctuations are not suitable for driving, especially long distance driving. If a sugar addict notices a slow loss of vision over several months, it is possible that a diabetic cataract is developing. Fortunately, cataract surgery treatment is now very effective, and cataract ultrasound emulsification and IOL implantation can be used to work or live normally with the eyes the day after surgery. Therefore, if you notice a slow loss of vision, you should visit your ophthalmologist to have your eyes examined so that he or she can assess the extent of your cataract and whether you need follow-up visits based on strict blood sugar control or surgical cataract removal IOL implantation to restore your vision. Make sure you can have a bright vision and drive your car safely and comfortably. If a person with diabetes suddenly experiences severe vision loss or blindness, then you may have diabetic retinopathy. Diabetic retinopathy is now the leading blinding eye disease, and it causes 25 times more double vision loss than in non-diabetic patients. In 8-10 years of diabetes, half of all glucose patients will develop retinopathy, and if blood sugar is not well controlled, more than 90% of glucose patients will develop retinopathy and eventually go blind after 10-15 years. The early and middle stages of diabetic retinopathy are generally not obvious in terms of vision loss, and it is an easy stage for sugar lovers to ignore, when the effect is still quite good if treated by medication and laser. However, once vision loss is detected and then come to the clinic, it has often developed to the middle and late stage, which means that the best treatment period has been missed, and the treatment effect is very poor. Since retinopathy caused by diabetes is irreversible, it is difficult to restore vision to its original state. Cataract is like the lens of a camera, if it is broken, the lens can be replaced by an IOL and the picture can be taken again. But the retina is like a film, if it is broken, it cannot be photographed, and what is more important is that the film cannot be replaced. Therefore, for sugar lovers who drive, those who have had the disease for more than 5 years should have their vision checked every 6 months for changes in vision and cataract development, and more importantly, have an experienced ophthalmologist evaluate the extent of retinal lesions. For sugar lovers with good vision but poor blood sugar control, especially those with frequent hypoglycemia, they should not drive; for sugar lovers with cataracts that seriously affect vision and driving safety, cataract surgery can be considered; for sugar lovers with retinopathy in the early and middle stages, they can protect their vision and drive safely through medication or laser treatment; for patients with advanced retinopathy, they can only save part of their vision through surgery such as vitrectomy. For patients with advanced retinopathy, they can only save part of their vision through vitrectomy and other surgeries, but most of them cannot reach the safe vision for driving. Therefore, the key to protecting vision, preventing blindness, and driving safely in patients with diabetic eye disease is regular ophthalmologic follow-up and timely treatment to restore or preserve vision based on smooth blood glucose control. The American Diabetes Association has established the following driving safety rules for people with diabetes: Regular blood glucose testing (once every 2 hours) during long distance driving to monitor blood glucose and prevent hypoglycemia or hyperglycemia. Take regular blood glucose tests (once every 2 hours) on long drives to monitor blood glucose to prevent hypoglycemia or hyperglycemia. Equip your car with a blood glucose monitor and candy or food for a quick blood glucose boost. Pull over and test your blood sugar as soon as you feel the symptoms of hypoglycemia. Eat a sugary soda or cookie or hard fruit candy as soon as you detect hypoglycemia and take a 15-minute break before testing your blood glucose to make sure it is within the treatment target. If your hypoglycemia subsides and you are conscious, then continue driving, otherwise stop driving. Follow up with an ophthalmologist every six months to evaluate diabetic eye lesions and to control low vision caused by diabetes-related eye disease.