Diabetes Specifications Oral and Diet Controlled Initial and Follow-up
Pilots with a diagnosis of diabetes mellitus controlled by diet alone are considered to meet the medical standards and are eligible for medical certification under the revised Part 67 medical standards. Medical documentation of your control is required at the time of the FAA medical examination. The aviation medical examiner may issue a certificate if your diabetes is diet controlled and you have the supporting documentation. You will need a report from your treating doctor and a current report of hemoglobin A1C.
Use of oral diabetes medication (or insulin) is disqualifying for medical certification under the regulations. If you are treated with medications or insulin, the aviation medical examiner cannot issue you a certificate. However, after initial clearance, the FAA may authorize the examiner to reissue future certificates if there are no significant adverse changes noted on the follow-up reports.
If you are controlling diabetes with oral medications, your treating doctor will need to provide evidence of adequate control, stabilization, and no adverse side effects or complications from medication for at least 60 days.
After the 60-day control period is completed, and within the next 30 days, a glycosolated hemoglobin (HgbA1C) should be done. Normal laboratory values for A1C hemoglobin will range from about 4.0%-7.5%. The FAA allows up to 9%. Be sure to include the actual laboratory report print-out and not just a statement from the treating physician.
There should be no evidence of significant medical or surgical complications, including cardiac, peripherovascular, renal, neurological, or ophthalmologic disease.
No beta-adrenergic blocking (beta-blockers) antihypertensive agents should be used. These medications can mask the symptoms of hypoglycemia and prevent you from being aware of a low blood sugar (hypoglycemic) condition. However, certain newer oral medications do not pose this risk and may be used with beta-blockers. These medications include:
- Acarbose (Precose)
- Rosiglitazone (Avandia)
- Miglitol (Glyset)
- Pioglitazone (Actos)
- Metformin (Glucophage)
Generally, follow-up evaluations will be required annually. Individual cases may require more frequent follow-up based on history.
If you have not previously applied for medical certification, make copies of all records for yourself and provide the completed testing to your aviation medical examiner at the time of your FAA physical examination. The AME will defer your application and send the paperwork for you to the FAA.
If this is a renewal of medical certification, send the records yourself to the FAA at the address below before visiting the AME for a new physical examination. Use express courier service, either overnight or 2-3 day delivery via FedEx, UPS, or Airborne. It will normally take 90-120 days before you receive a response. Each case is evaluated on an individual basis, however, and significantly longer delays can occur, depending on the case history. If any of the required information is left out, it will take longer for the FAA to reach a decision.
When the FAA approves your case, you will receive an authorization letter instructing the AME to issue your certificate if you are found otherwise qualified.