The FAA may consider certification, under the Special Issuance provisions of the Federal Aviation Regulations, of individuals with insulin-treated diabetes mellitus (ITDM). The following restrictions apply: ITDM individuals:
In order to be considered for aeromedical certification, an individual with ITDM should have been receiving appropriate insulin treatment (injections or pump) for at least six months prior to submitting a request for medical certification. All FAA-allowed oral diabetes medications may be used in combination with insulin therapy; however, the FAA does not allow the use of beta-blockers (blood pressure medications) in tandem with insulin and oral medications. Januvia and Byetta are newer diabetes medications, and are also NOT allowed with insulin therapy.
For initial certification:
A period of one year of demonstrated stability is required following the first episode of hypoglycemia.
Preflight: Not more than 1/2 hour before takeoff, the pilot shall establish and document a blood glucose concentration equal to or greater than 100 milligrams/deciliter (mg/dl) but not greater than 300 mg/dl. If the concentration is within 100-300 mg/dl, flight operations may commence. If less than 100 mg/dl, an appropriate glucose snack (at least 10 gm.) must be ingested and a recheck done. If over 300 mg/dl, the flight must be postponed.
In flight: One hour into the flight, at subsequent hourly intervals, and within one half hour of landing, the pilot shall monitor the blood glucose concentration. If the concentration is less than 100 mg/dl, a 20 gm snack shall be ingested. If the concentration is between 100-300 mg/dl, no action is required. If the concentration is greater than 300 mg/dl, the pilot 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. With respect to determining blood glucose determinations in flight, the airman must use good judgment in deciding whether measuring concentrations or operational demands of the flight environment, such as adverse weather, air traffic control concerns, or engine trouble should take priority. In cases where operational considerations take priority, the airman should ingest a 10 gm glucose snack, fly the airplane, and measure blood glucose concentrations one hour later. If measurement is not practicable at that time, the airman must ingest a 20 gm glucose snack and land at the nearest suitable airport until a determination of the blood glucose concentration can be made.
For subsequent recertification: Individuals who are granted special issuance of third class airman medical certificates must:
Helps you find the contact information for submitting your medical records.
Updated March 18, 2011
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