Rose, I always ask for early appointments to get them out of the way but I don't have to drive an hour to get to them.
When I have a day trip with a travel club I go with, I don't eat or take my medication before I go. I do take a snack just in case I'm "fading" with my diabetes but I haven't had to use the snack! We always eat lunch around 11:30-12:00 when on these trips and that's when I will take my medication. It's just a few hours later than usual and I certainly can afford to miss a meal!
When I have an early doctor's appointment and want to run errands afterwards, I will make myself a peanut butter sandwich and leave it in the car, along with some ice water. Again, I don't eat breakfast or take my meds. I take the meds after the appointment....right before I eat the sandwich.
This works for me. Maybe it will work for you. Try it at home and see what happens. Doing this occasionally shouldn't hurt you and it makes these early appointments far more managable.
Sherrine