You’ve just finished off a long workday and are eager to head home to relax. You step out of the office onto a busy city street, and breathe a sigh of relief that you don’t need to get behind the wheel in downtown traffic yourself. Instead, you use your smartphone to summon a ride-sharing vehicle to pick you up.

Just as the alert comes that the driver’s arriving, you also happen to get a more pressing alarm that your blood sugar is low and dropping fast. As you climb into the car, you happen to notice a sign on the seat-back in front of you: “Please, no eating or drinking in my car!

What do you do?

Or, try this example on: You have a history of dangerously low blood sugars and as a result have a beloved diabetes alert dog with you to keep you safe. But whenever you call an Uber or Lyft and the driver arrives, they suddenly cancel the ride once they get a glimpse of your dog waiting with you.

Both of those scenarios have happened to members of our Diabetes Community recently. And as more people turn to ride-sharing services, navigating these types of health-related issues is becoming an ever more common concern.

In fact, both Uber and Lyft are fighting court battles that touch on the issue of whether the companies and drivers are subject to the American Disabilities Act, requiring them to accommodate riders’ special health needs. One federal judge has ruled that Uber must comply with ADA requirements, despite the ride-sharing company’s contention that it’s not responsible for providing disability-accessible transportation because it is a software developer, responsible only for the design of its smart phone app, and because it does not own any of the vehicles used to transport passengers.

This leaves a question for people with diabetes — and all sorts of disabilities — about where to turn if we need accommodations from a ride-sharing company.

When queried in early November, the American Diabetes Association told us they had not yet handled any legal cases or community questions on this topic, but since then we’ve become aware of one instance in Chicago in which the ADA’s been called upon to assist, in what appears to be the first offiicial diabetes ride-sharing case of its kind.

That Chicago instance was described by D-advocate Brianna Wolin, who was diagnosed two decades ago as a 4-year-old and happens to be a daughter and granddaughter of T1D women as well.

On Oct. 31, she shared on Twitter: “Just got yelled at for treating a low blood sugar in an Uber car — made me get out. Unacceptable.” Her follow-up tweets noted that the driver insisted that riders are not allowed to eat or drink anything in the car, and when she informed him about diabetes, he simply said, “So why did you wait until you were in my car?” He stopped the car and forced her to get out — in a strange place, in frigid snowy Chicago weather, and while her blood sugar was low.

“Good thing I was in the 70s (blood sugar range) at that time, not 50s or under,” Wolin shared.

She later called in help from her endocrinologist, who contacted the American Diabetes Association to move forward on this complaint against Uber. She’s frustrated about not yet seeing an adequate response from the ride-sharing company, but she has cautionary advice for those in the D-Community.

“I would say it’s not worth fighting the driver because you don’t want to get the driver into an angry position behind the wheel,” she says.

Recent news coverage out of San Francisco also reports about longtime type 1 Talia Lubin, who’s filed a lawsuit over the fact that Lyft drivers have repeatedly cancelled her rides when they pull up and see her medical service dog. A law student at UC Hastings College of Law, Lubin has lived with T1D for more than five years and has a diabetes alert dog named Astra who protects her from experiencing severe hypos.

According to media reports, Lubin says that during a recent visit to the Bay Area she was cancelled on by a Lyft driver who pulled up and saw her dog, although the dog was wearing a special “Service Dog” and “Medical Alert” vest.

In another instance, Lubin says her mother called the Lyft for her and explained to the driver that Astra sits at Lubin’s feet and has a small travel tarp underneath to prevent any hair from being left in the car. After reminding that driver about the legal requirements, he did allow the dog into the car but “continued to harass her throughout the drive about it.”

Lubin said she reported the incident to Lyft’s Trust and Safety team leading to a temporarily suspension of the driver’s account and reminder of his legal obligations for passengers with disabilities and those with service animals. The media reports say she also received an offer of a $5.00 credit.

Apparently, Lyft offered this statement as reported by the local ABC7 news station:

“What the rider described is unacceptable. Community safety and inclusivity are core to our mission, and we have a strict Service Animal policy that requires all drivers to accommodate riders traveling with service animals. Failure to abide by that policy can result in being removed from the Lyft community.”

Lubin says she doesn’t believe enough is being done to train drivers about these equal access issues — despite the latest lawsuits against the ride-sharing companies that are now pending in federal court.

The outcry over this issue is getting louder, with mainstream headlines yelling that ride-hailing companies are leaving people with disabilities behind.

In response, Uber and Lyft have both posted policy statements on their websites and mobile apps addressing this issue of disability access. Uber’s page notably now includes an entire section covering service animals that riders may have with them. Meanwhile, Lyft’s “Accessible Vehicle Dispatach” page includes details listed by state, and the company has created an “Access Mode” on its mobile app where riders can notify a driver that they have specific accommodation needs.

In summer, Lyft announced via blog post that it’s piloting a new wheelchair accessible vehicle (WAV) service in San Francisco and Los Angeles counties. This expands on their exsiting on-demand transportation options for fixed frame, non-collapsible wheelchair users. “Lyft riders will now be able to request a WAV, in app by enabling Access Mode. The vehicles, 2019 Toyota Siennas, are operated by certified drivers provided by First Transit and will be available exclusively for Lyft app WAV ride requests,” the post explains.

Unfortunately, Lyft’s publicized “Commitment to Accessibility” does not include any detail on how they handle people with other health issues, like diabetes that might require eating in a car, which is otherwise forbidden.

Anyone in the diabetes community who’s faced any potentially discriminatory issues can check out the American Diabetes Association’s resource page on your legal rights, or call 1-800-DIABETES to request a free information packet, plus assistance from a legal advocate.

Interestingly, opinions do vary on the topic of ride-sharing mishaps, and we’ve seen some folks in the D-community agrue that it should be each individual driver’s responsibility to deal with these scenarios correctly. One Seattle D-peep wondered if complaining to Uber/Lyft about a situation like this had the goal of getting the driver fired, and what that would accomplish. When asked what she would do if facing a low during the ride, she offered this: “I’d ask: Is this a medical emergency? NO = Ride continues at driver’s discretion; YES = Ride immediately terminated and 911 called. An Uber driver isn’t a medical professional and can’t be expected to know about all medical conditions and ailments. This was unfortunate, but please don’t destroy peoples lives because you’re feeling self-entitled.”

Clearly, as with everything diabetes, no one size fits all.

To some extent, it may come down to how prepared each of us is to treat hypoglycemia on the go. Do we always carry supplies and backups? Even if we do, what about that one time when when things just go south?

This all came home for me personally during some recent travels out of state — both work trips in larger cities requiring more walking than I’m used to. In both instances, I had called a ride-share, and just about the time I was about to get into the cars, my CGM began to alarm and vibrate to alert me to a low blood sugar.

Fortunately, I typically carry glucose tabs as well as a bottle of apple juice in case of emergencies. So I was able to quickly and discreetly chew on a few tabs or chug that juice. Yet, in both of those cars I did notice signs stating, “No eating or drinking in car, please.”

I didn’t press my luck by calling attention to myself or asking any questions, in part because I realize how scary a low can be, especially while en route in a stranger’s car.

It’s just one more thing we must think about when planning our travels and navigating life with diabetes. We have to remind ourselves that we do live with a disability, and that’s a legally protected status. It’s good to know we can call upon the ADA for representation and assistance if needed.

In the meantime, we’re keeping a close eye on how Lyft or Uber handle these recent complaints.