Even as a T2 without insulin, it took the FAA six months to approve my Class 3 medical and I have
excellent control.
For insulin-dependent diabetics, here are the complete FAA guidelines:
PROTOCOL FOR INSULIN-TREATED DIABETES MELLITUS - TYPE I & TYPE II
The FAA has established a policy that permits the special issuance medical certification of insulin-
treated applicants for third-class medical certification. Consideration will be given only to those
individuals who have been clinically stable on their current treatment regimen for a period of 6-
months or more. Consideration is not being given for first- or second-class certification.
Individuals certificated under this policy will be required to provide substantial documentation
regarding their history of treatment, accidents related to their disease, and current medical
status. If certificated, they will be required to adhere to stringent monitoring requirements and
are prohibited from operating aircraft outside the United States. The following is a summary of the
evaluation protocol and an outline of the conditions that the FAA will apply:
A. Initial Certification
1. The applicant must have had no recurrent (two or more) episodes of hypoglycemia in the past 5
years and none in the preceding 1 year which resulted in loss of consciousness, seizure,
impaired cognitive function or requiring intervention by another party, or occurring without
warning (hypoglycemia unawareness).
2. The applicant will be required to provide copies of all medical records as well as accident and
incident records pertinent to their history of diabetes.
3. A report of a complete medical examination preferably by a physician who specializes in the
treatment of diabetes will be required. The report must include, as a minimum:
a. Two measurements of glycosylated hemoglobin (total A1 or A1c concentration and the laboratory
reference range), separated by at least 90 days. The most recent measurement must be no more
than 90 days old.
b. Specific reference to the applicant’s insulin dosages and diet.
c. Specific reference to the presence or absence of cerebrovascular, cardiovascular, or peripheral
vascular disease or neuropathy.
d. Confirmation by an eye specialist of the absence of clinically significant eye disease.
e. Verification that the applicant has been educated in diabetes and its control and understands
the actions that should be taken if complications, especially hypoglycemia, should arise. The
examining physician must also verify that the applicant has the ability and willingness to
properly monitor and manage his or her diabetes.
f. If the applicant is age 40 or older, a report, with ECG tracings, of a maximal graded exercise
stress test.
g. The applicant shall submit a statement from his/her treating physician, Examiner, or other
knowledgeable person attesting to the applicant's dexterity and ability to determine blood
glucose levels using a recording glucometer.
NOTE: Student pilots may wish to ensure they are eligible for medical certification prior to
beginning or resuming flight instruction or training. In order to serve as a pilot in command,
you must have a valid medical certificate for the type of operation performed.
B. Subsequent Medical Certification
1. For documentation of diabetes management, the applicant will be required to carry and use a
whole blood glucose measuring device with memory and must report to the FAA immediately any
hypoglycemic incidents, any involvement in accidents that result in serious injury (whether or
not related to hypoglycemia); and any evidence of loss of control of diabetes, change in
treatment regimen, or significant diabetic complications. With any of these occurrences, the
individual must cease flying until cleared by the FAA.
2. At 3-month intervals, the airman must be evaluated by the treating physician. This evaluation
must include a general physical examination, review of the interval medical history, and the
results of a test for glycosylated hemoglobin concentration. The physician must review the record
of the airman's daily blood glucose measurements and comment on the results. The results of these
quarterly evaluations must be accumulated and submitted annually unless there has been a change.
(See No. 1 above - If there has been a change the individual must report the change(s) to the FAA
and wait for an eligibility letter before resuming flight duties).
3. On an annual basis, the reports from the examining physician must include confirmation by an eye
specialist of the absence of significant eye disease.
4. At the first examination after age 40 and at 5-year intervals, the report, with ECG tracings, of
a maximal graded exercise stress test must be included in consideration of continued medical
certification.
C. Monitoring and Actions Required During Flight Operations
To ensure safe flight, the insulin using diabetic airman must carry during flight a recording
glucometer; adequate supplies to obtain blood samples; and an amount of rapidly absorbable glucose,
in 10 gm portions, appropriate to the planned duration of the flight. The following actions shall be
taken in connection with flight operations:
1. One-half hour prior to flight, the airman must measure the blood glucose concentration. If it is
less than 100 mg/dl the individual must ingest an appropriate (not less than 10 gm) glucose snack
and measure the glucose concentration one-half hour later. If the concentration is within 100 --
300 mg/dl, flight operations may be undertaken. If less than 100, the process must be repeated;
if over 300, the flight must be canceled.
2. One hour into the flight, at each successive hour of flight, and within one half hour prior to
landing, the airman must measure their blood glucose concentration. If the concentration is
less than 100 mg/dl, a 20 gm glucose snack shall be ingested. If the concentration is 100 --
300 mg/dl, no action is required. If the concentration is greater that 300 mg/dl, the airman
must land at the nearest suitable airport and may not resume flight until the glucose
concentration can be maintained in the 100 -- 300 mg/dl range. In respect to determining blood
glucose concentrations during flight, the airman must use judgment in deciding whether
measuring concentrations or operational demands of the environment (e.g., adverse weather,
etc.) should take priority. In cases where it is decided that operational demands take
priority, the airman must ingest a 10 gm glucose snack and measure his or her blood glucose
level 1 hour later. If measurement is not practical at that time, the airman must ingest a 20
gm glucose snack and land at the nearest suitable airport so that a determination of the blood
glucose concentration may be made.
www1.faa.govversionOpen ↗
3/03amemanual/PROTOCOLS/DIABETES_INSULIN.htm
[email hidden] (George Rachor) wrote in :"]news:[email hidden]:
Quoted message said:
My understanding is Insulin treaded diabetics have much greater difficulty getting the medical
certificate needed for "Pilot in command".
I heard the other day there are over 700 diabetics in the US with current pilot licences.
1. Not allowed to fly commercial.
2. Must be in good control.
3. Must test before, during, and after flight.
Difficult but not impossible.
I don't have the control down well enough to even think about it yet.
George Rachor
Marshall said:I thought that diabetics could not become pilots?
Quoted message said:George Rachor said:I've been diagnosed with Type 2 for about 8 years and just can't seem to get my BG numbers down
to a normal level.
I'm currently approaching the max limit for Glucophage, and am also taking Actos. I'm pretty
worried that my Doc is going to reccomend Insulin pretty soon.
I'm exercising on a moderate level on a treadmil for 1/2 hour morning and evening on a pretty
regular schedule.
My bg levels range from 150 to 200 about 2 hours after meals even with the exercise.
Taking the step to Insulin greatly complicates things as I do international travel as well am
looking to hopefully become a pilot.
I started this morning to stretch the exercise to 1 hour sessions to see what effect than
might have.
The lowest BG number I've ever seen is a 96 and that was after a pretty long hike hunting.
Any thoughts?
George Rachor [email hidden]
Quoted message said:--
homepage.mac.commkatzmanOpen ↗
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George L. Rachor Jr. [email hidden] Hillsboro, Oregon http:rachors.com United States of
America Amateur Radio : KD7DCX
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T2 - A1c 5.2
