Diabetic driver William Swale, 69, spoke publicly for the first time on Tuesday as he gave evidence to Melbourne Coroners Court on the collision in Daylesford, 110km northwest of Melbourne.
He suffered a severe hypoglycaemic episode and passed out while driving his white BMW SUV, causing it to crash into patrons outside the Royal Daylesford Hotel, about 6.07pm on November 5, 2023.
Mr Swale mounted a kerb and drove into patrons seated in the pub's beer garden.
Pratibha Sharma, 44, her daughter Anvi, 9, and partner Jatin Kumar, 30, their friend Vivek Bhatia, 38, and his son Vihaan, 11 were killed, and six others were injured.
Mr Swale was charged with 14 offences, including five counts of culpable driving causing death. But all charges were struck out by a magistrate in September 2024, who found his actions were involuntary.
Coroner Dimitra Dubrow is investigating how the collision occurred, including Mr Swale's  prior diabetic management, in the nine-day inquest.
Counsel assisting Rishi Nathwani KC described the crash as deeply distressing and tragic.
"It is hoped than an incident such as this does not occur again," he told the court.
He said the coroner will investigate awareness, education and management of diabetic drivers, as well as laws around outdoor dining.
Mr Swale had objected to giving evidence to the inquest but was compelled by the coroner to do so.
He told the court on Tuesday the only time he recalled engaging in a diabetes training course was in 1994, when he was diagnosed with type-1 diabetes.
He was shown documents Mr Nathwani said were sent to him, including emails from his endocrinologist and a brochure from VicRoads, in the years before the crash, on driving and diabetes.
"Not formal training, but that doesn't mean I didn't have conversations with Dr Cohen (his endocrinologist)," he told the court.
Mr Swale said he was not aware he was under any obligation to register he was a diabetic with VicRoads until June 2021, and said he could not remember reading the brochure they sent him.
He said he had not told RACV, his insurance provider, that he had diabetes in the 30 years he was with them.
Mr Swale said he did not drive anymore, but at the time he had a general rule that he could drive if his fasting blood glucose levels were at 8mmol/L, and at 5mmol/L he would normally have something to eat.
He said he always carried jellybeans and other snacks in his car in case his sugar dropped, and fruit and nuts were inside his car on the day of the crash.
However, he did not eat anything as his levels dropped to 2.9mmol/L in the hour before the crash.
"At that stage I was feeling hypoglycaemic and unable to make rational decisions," Mr Swale said.
He was leaving the town of Clunes after spending the weekend at a clay shooting event and pulled over in Daylesford to go into the Winespeake Cellar + Deli to get some food.
Mr Swale accepted he must have checked his blood glucose monitoring device around this time, at 5.17pm, as records showed he did, and it had dropped to 2.9mmol/L.
He felt "dark" and "vague" as he entered the deli but was told he couldn't get a table, and the last thing he remembered was leaving the store, he said.
Asked whether he tried to get takeaway food, Mr Swale said "no because I was in a very, very hypoglycaemic state at the time".
The court was told his device's alarm went off 10 times to indicate he had low glucose, but Mr Swale said he did not hear it.
After leaving the deli, the next thing he said he remembered was speaking to paramedics at the scene.
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