Last updated: 31 October 2026
This page summarises the Group 2 (lorry and bus) rules. For background, see our HGV and diabetes hub, including blood sugar monitoring and which medicines avoid the need for testing.
Book your HGV / D4 medical with Dr Steve Walton, Sheffield S12: £80, 30-minute GP examination
The quick answer by treatment
| Treatment | Tell DVLA? (lorry/bus) | Glucose testing |
|---|---|---|
| Diet and lifestyle only | No | Not required |
| Metformin, gliptins (DPP-4), SGLT2 inhibitors, GLP-1 injections and other non-insulin injectables | Yes, form VDIAB1GEN | Not required by DVLA |
| Sulphonylureas (for example gliclazide) or glinides (repaglinide, nateglinide) | Yes, form VDIAB1SG | At least twice daily and at times relevant to driving |
| Insulin | Yes, stop driving lorries/buses first, form VDIAB1I | Twice daily, before driving and every 2 hours while driving |
Source: GOV.UK Diabetes and driving and DVLA's Assessing fitness to drive, chapter 3.
Diet-controlled diabetes
You don't need to tell DVLA, provided you meet the general requirements and have no disqualifying complications such as eye damage affecting your vision.
Metformin, gliptins, SGLT2 inhibitors and GLP-1 injections
These medicines carry little risk of hypos on their own. A lorry or bus driver may keep driving but must notify DVLA. DVLA may license you if you're under regular medical review and have no disqualifying complications. This is a difference from car licences, where no notification is usually needed for these medicines.
Gliclazide and other sulphonylureas or glinides
These can cause hypos, so the rules are tighter. You may drive but must notify DVLA, and to be licensed (for 1, 2 or 3 years) you must:
- have had no severe hypo in the last 12 months (severe means you needed someone else's help)
- have full awareness of hypos
- test your glucose at least twice daily and at times relevant to driving: before the first journey and at least every 2 hours while driving
- understand the risks of hypoglycaemia
- be under regular medical review with no disqualifying complications
Insulin-treated diabetes and an HGV licence
Insulin users can now hold a lorry or bus licence, but the requirements are strict. You must stop driving Group 2 vehicles when you start insulin and tell DVLA (form VDIAB1I). Then:
- your condition must be stable for at least one month before you apply
- you need full awareness of hypoglycaemia
- no severe hypo in the previous 12 months, including episodes during sleep
- test at least twice daily, including non-driving days, before the first journey and at least every 2 hours while driving, with no more than 2 hours between checks
- at least 4 continuous weeks of readings stored on a meter with a memory, taken while on insulin
- an annual examination by an independent consultant diabetologist, arranged by DVLA
- no disqualifying complications, such as visual field loss
The licence is issued for 1 year at a time.
Can I use a Libre or other CGM?
Yes. DVLA now accepts continuous glucose monitoring for lorry and bus drivers if the device is approved for non-adjunctive use (making treatment decisions on its readings alone). You must carry a finger-prick meter as backup, and use it if the sensor fails or the reading doesn't match how you feel. CGM alarms should be set at 4.0 mmol/L or higher.
Hypos: what you must report
- Any severe hypo (needing another person's help), including during sleep. Lorry and bus drivers must stop driving and notify DVLA.
- Any severe hypo while driving, whatever licence you hold.
- Losing your hypo warning symptoms. Lorry and bus drivers must have full awareness, so the Group 2 licence will be refused or revoked.
Diabetes and your D4 medical
Section 2 of the D4 asks how your diabetes is treated, how you monitor, whether you've had a hypo, and about retinal laser treatment. Bring your meter or CGM and a list of medicines. Eye complications matter too: diabetic retinopathy can affect the visual field, which must meet the Group 2 standard.
If your diabetes treatment is changing, tell your diabetes team that you drive for a living. Sometimes a different medicine avoids the extra requirements altogether.
Book your HGV medical
I'm an NHS GP partner and have examined lorry and bus drivers since 2002. A D4 at Stonecroft Medical Centre, Sheffield S12, is a full 30-minute examination for £80.
Book your HGV / D4 medical with Dr Steve Walton, Sheffield S12: £80, 30-minute GP examination
Frequently asked questions
Can I drive an HGV if I'm on insulin?
Yes, if you meet DVLA's strict criteria: full hypo awareness, no severe hypo in 12 months, regular glucose testing with 4 weeks of stored readings, and an annual review by an independent consultant diabetologist. You must stop driving lorries and buses and tell DVLA when you start insulin.
Do I need to tell DVLA I'm on metformin if I drive a lorry?
Yes. Lorry and bus drivers must notify DVLA about diabetes treated with tablets or non-insulin injections, including metformin. Car drivers usually don't need to.
Does gliclazide affect my HGV licence?
Gliclazide can cause hypos, so you must notify DVLA, test your glucose at least twice daily and around driving, have full hypo awareness and no severe hypo in the last 12 months.
Can I use a Freestyle Libre for HGV driving?
DVLA accepts CGM devices approved for non-adjunctive use for lorry and bus drivers, but you must carry a finger-prick meter as backup.
Do I need to tell DVLA about diet-controlled diabetes?
No. Diabetes managed by diet alone does not need to be reported, for car or lorry licences, provided there are no disqualifying complications.
Sources (GOV.UK / DVLA)
- Diabetes and driving (GOV.UK)
- Assessing fitness to drive, chapter 3: Diabetes (GOV.UK)
- INF4D notes for the D4 (GOV.UK)
Medical standards checked against DVLA's Assessing fitness to drive (November 2025 edition) and GOV.UK guidance, October 2026. Always check GOV.UK for the latest rules.