[Updated Nov 2023]
The medical condition of diabetes can cause either high or low blood glucose, depending on whether the person takes medication, when he or she has last eaten, and other factors that can induce the classic symptoms of a diabetic crisis.
As EMTs and paramedics know from treating patients in a diabetic crisis, the blood sugar alteration can cause symptoms identical to operating a vehicle while intoxicated. A nonmedical person would usually not be able to tell the difference between OVI, a serious traffic violation in Ohio and OVI-like behavior resulting from diabetic ketoacidosis.
Sobriety tests can yield inaccurate readings
Unfortunately, a diabetic person suffering from a severe alteration in blood sugar can cause a false positive in breath test administration by police. The National Highway Traffic Safety Administration reports that people who are diabetics can have acetone levels from hundreds to a thousand times higher than those who are nondiabetic. Low blood sugar causes the liver to produce ketones, a substance that triggers false positive readings in breath test equipment. Untreated, ketones continue to build up in the diabetic person’s system and reach a state of diabetic ketoacidosis—a severe condition that requires emergency medical treatment. Without immediate intervention, DKA can cause death.
A field sobriety test given to a person with uncontrolled diabetes can appear to confirm alcohol or substance abuse intoxication. Bystanders may tell a police officer that the driver emerged from a vehicle unable to ambulate well. The person might display garbled speech or combative behavior. While these are symptoms of alcohol intoxication, they also apply to a diabetic person suffering from ketosis.
Diabetics and blood alcohol readings
Blood or urine tests not administered under an exacting series of precise conditions that include sample collection timing, storage and thorough training in correct testing methodology give inaccurately high BAC readings. A lack of justice system training about diabetes prompted The American Diabetes Association to produce a well-documented report about diabetic rights and criminal defense.
The NHTSA publication entitled “The ABCs of BAC, A Guide to Understanding Blood Alcohol Concentration and Alcohol Impairment,” compared the effects of alcohol intoxication in drivers at various BAC levels and the effects on driving; those between a sober diabetic person and an inebriated person showed nearly identical symptoms.
Unfortunately, law enforcement arrests many people with diabetes when they experience low blood sugar. Officers recognize OVI/DUI symptoms but lack education regarding their similarity to a diabetic crisis. Courts, equally uninformed regarding diabetes, often uphold OVI convictions against innocent people whose only “crime” was being under the influence of a legitimate medical condition that mimics illegal alcohol intoxication.