Several new types of diabetes medications have gained FDA approval in the last year, and the FAA has recently established policy for two of these drugs. Onglyza (saxagliptin) is one of a group of drugs that inhibits an enzyme known as DPP4, resulting in an increase in insulin levels from beta cells in the pancreas and a decrease in the secretion of glucagon, a hormone secreted by the pancreas that raises blood sugar. The result is a more consistently stable level of blood glucose, especially following a meal. More stable blood glucose levels means better diabetes control, so this drug will add to the arsenal of medications available to treat people with Type 2 diabetes.
Another diabetes drugs that the FAA will allow is Victoza (liraglutide). This is an injectable drug that’s administered just under the skin, and is in the class of drugs called Glucagon-Like Peptide-1 (GLP-1) receptor agonists. Victoza acts similarly to Onglyza in that the active ingredient liraglutide stimulates insulin secretion and lowers glucagon secretion.
Both these drugs are often prescribed for combined therapy with other diabetes medications, and the FAA is concerned about possible hypoglycemia (low blood sugar) with some combinations of drugs, so a matrix will be developed to identify the different combinations of drugs that the FAA will allow, along with appropriate monitoring periods of use before a pilot is considered safe to fly. Soon as that “decision tree” is published by the FAA, we’ll make it available as part of our online diabetes information report.
One additional update we just received from the FAA concerns the use of Reglan (metaclopramide) for gastroesophageal reflux. That medication was previously allowed with a usage limitation, but has now been reclassified as not allowed because of an adverse side effect profile.
July 14, 2011