Diabetes, Diet and Oral Medication

Diabetes, Diet, and Oral Medication

Endocrine System — Diabetes, Diet and Oral Medication

The FAA allows special issuance certification for diabetes controlled with oral medications. If controlled by diet and exercise only, your aviation medical examiner may issue a certificate at the time of examination if you have the following information:

  • A current status report from your treating doctor that mentions the absence of significant medical or surgical complications including cardiac, peripherovascular, renal, neurologic, or ophthalmologic disease, and:
  • A current report of hemoglobin A1C

For special issuance consideration on oral medications, you will need:

  1. Laboratory Reports. After being on medications for the required observation period (see chart below) you will need a report of glycosolated hemoglobin (HgbA1C). Normal laboratory values for A1C hemoglobin will range from about 5.0% to 7.0 %. For medical certification purposes, the FAA will allow up to 8.9%. Be sure to include the actual printed laboratory report and not just a statement from the treating physician. Hgb A1C test should be done after the required wait time and submitted to the FAA within 30 days after testing.
  2. A detailed, current diabetes evaluation report from your treating physician.

The number of available medications to treat diabetes is increasing, and with that comes increasing limitations on which drug combinations the FAA allows. The following chart lists the most common medication combinations, the acceptability with other medications, and the required observation time after starting the medication:

 

Medications

Acceptable with Other Oral-agents?

Wait-Time

Acceptable with Insulin?

Acceptable with Beta-Blocker?

Sulfonylureas

Yes

60 days

No

Yes

Gliclazide

 

 

 

 

Glipizide (Glucatrol)

 

 

 

 

Glimepiride (Amaryl)

 

 

 

 

Glibenclamide (Glyburide)

 

 

 

 

 

 

 

 

 

Biguanide

Yes

60 days

Yes

Yes

Metformin (Glucophage)

 

 

 

 

 

 

 

 

 

 

Meglitinides

Yes

60 days

Yes

Yes

Nateglinide (Starlix)

 

 

 

 

Repaglinide (Prandin)

 

 

 

 

 

 

 

 

 

Alpha-Glucosidase inhibitors

Yes

60 days

Yes

Yes

Acarbose , Precose

 

 

 

 

Miglitol (Glyset)

 

 

 

 

 

 

 

 

 

Thiazolidinedione

Yes

60 days

Yes

Yes

Pioglitazone (Actos)

 

 

 

 

Rosiglitazone (Avandia)

 

 

 

 

 

 

 

 

 

Glucagon-Like Peptide 1 Mimetics

Yes

Requires two weeks observation when added to other meds; 4 weeks with Sulfonylurea

No

Yes

Exenatide (Byetta)

 Allowed in combination with : Metformin, TZD (Thiazolidenedione), SFU (Sulfonylurea), Methformin and TZD, Metformin and SFU, Insulin, and Insulin and Metformin, Insulin and TZD, Insulin and Metformin and TZD

 

 Yes

 Yes

Liraglutide (Victoza)

 

 

 

 

 

 

 

 

 

Dipeptidyl-Peptidase-4 Inhibitors

Acceptable only with Metformin and/or Thiazolidinedione

Requires 14 days observation when added to another medication. If both meds are started at same time, 60 days observation

No

Yes

Sitagliptin (Januvia)

 

 

 

 

Saxagliptin (Onglyza)

Allowed in combination with : Metformin, TZD (Thiazolidenedione), SFU (Sulfonylurea), Metformin and TZD, Metformin and SFU, Insulin, and Insulin and Metformin, Insulin and TZD, Insulin and Metformin and TZD 

 

 Yes

 Yes

Metformin/Sitagliptin (Janumet)*

*Acceptable with thiazolidinedione only

 

 

 

Amylin Analogue

 

 

 

 

Pramlintide (Symlin)

Yes

 

No

Yes

 

 

 

 

 

Lantus (insulin)

Yes

6 months

-

Yes

 

 

 

 

 

Use this address to submit your information to the FAA.

Generally, the FAA will grant six-year AASI authorizations with annual follow-up. Individual cases may require more frequent reevaluation, based upon individual history.

AME Assisted Special Issuance (AASI) for Diabetes, Oral Medication

After initial certification by the FAA, subsequent renewals for diabetes may qualify for AME Assisted Special Issuance (AASI), a process that provides examiners the ability to issue an airman medical certificate to an applicant who has a medical condition that is disqualifying under 14 CFR Part 67.

Examiners may reissue an airman medical certificate if you provide the following:

  • An authorization letter granted by the FAA.
  • A current status report performed within the preceding 90 days that includes all the required follow-up items and studies listed in the authorization letter and that confirms no progression of disease.

Contact information for mailing records to the FAA.

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